Thyroid Storm
What causes a thyroid storm after surgery?
(Massive release of stored T3/T4)
What hormone is missing or ineffective in DI?
(ADH)
What are two common signs of hypothyroidism in elderly clients?
(Fatigue, cold, constipation, bradycardia)
What kind of radiation treatment is I-131?
(Radioactive iodine for hyperthyroidism/cancer)
You observe excessive sweating & restlessness. What’s your first step?
(Take vitals & report)
Name 3 signs of thyroid storm.
(Fever, tachycardia, agitation, HTN, sweating)
What are two hallmark symptoms of DI?
(Polyuria and polydipsia)
Why do we “start low and go slow” with thyroid meds?
(To avoid cardiac complications)
Name 2 safety rules for VNAs during I-131 care.
(Keep distance, no fluid contact)
Can a VNA administer DDAVP or PTU?
(No – must be RN/LVN/provider)
What medication blocks sympathetic symptoms?
(Propranolol)
What is the urine specific gravity in DI?
(Low, ~1.001–1.005)
What dangerous condition can result from untreated hypothyroidism?
(Myxedema coma)
Why must patients not share utensils or bedding?
(Body fluids are radioactive)
What’s the best way to report changes?
SBAR format: (Situation, Background, Assessment, Recommendation)
What is PTU’s role in thyroid storm?
(Blocks T3/T4 production & conversion)
What medication is given for Central DI?
(Desmopressin / DDAVP)
As a VNA, what would you report immediately?
(New confusion, extreme cold, low HR)
What should a VNA do if a family member wants to help with toileting?
(Advise RN, explain radiation risk)
What might you say to reassure a family member about fluid replacement in DI?
(“Her body is losing too much water – we’re just replacing what she’s missing”)
Why do we use cooling blankets?
(To reduce core temp & prevent CNS/organ damage)
Why does DI cause hypernatremia?
(Loss of water without sodium retention)
What nursing measures help with hypothyroidism care?
(Encourage warmth, activity, fiber, monitor vitals)
What kind of PPE is needed during close care?
(Gown, gloves, shield signs as per protocol)
A patient is voiding 500 mL/hour – what should you do?
(Measure, document, and report it immediately. Normal is between 30-80).