Author Question: The nurse is reviewing orders for a patient in myxedema coma. Which orders should the nurse question ... (Read 79 times)

asmith134 · **on:** Jun 25, 2018

The nurse is reviewing orders for a patient in myxedema coma. Which orders should the nurse question before administering to this patient?

Select all that apply.
1. regular insulin IV at 5 units per hour
2. cooling blanket
3. methimazole (Tapazole) 15 mg PO daily
4. pulse oximetry and vital signs hourly
5. serum TSH level daily

Question 2

The nurse is reviewing the relationship between thyroid hormone and iodine with a group of nursing students. The nurse knows further teaching is required when a student states that patients may experience iodine deficiency and hypothyroidism if they:

1. eat large amounts of shellfish.
2. use prescribed lithium carbonate.
3. eat large amounts of turnips or rutabagas.
4. live in an area where iodine is deficient in the soil.

Liddy · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 1,2,3
Myxedema coma is characterized by hypoglycemia. There is no evidence that IV insulin is indicated for this patient, and administering it would likely be harmful to an already hypoglycemic patient. Patients with myxedema are often hypothermic, and a cooling blanket would also be harmful. Methimazole (Tapazole) interferes with thyroid hormone and would be contraindicated for a patient in myxedema coma. Hourly vital signs with oximetry and daily serum TSH monitoring are appropriate for this patient.

Answer to Question 2

Correct Answer: 1
Shellfish contains iodine. Drugs such as lithium carbonate and foods such as turnips and rutabagas interfere with thyroid hormone synthesis. Living in an area where iodine is deficient in the soil may also lead to thyroid deficiency and hypothyroidism.