myxedema coma

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Myxedema Coma:

Myxedema Coma AA Presented by Karen Larson, MBA/TM, MSN, RN 1

Definition:

Definition Severe Hypothyroidism. Hypothermia. Very high mortality 1:3 Undiagnosed Hypothyroidism or usually Untreated . Typical patient: elderly female with longstanding hypothyroidism.

Manifestations of Myxedema Coma:

Manifestations of Myxedema Coma Typical Stigmata : dry skin, delayed reflex relaxation, generalized weakness, edema, transverse scar. Alterations- mental status. Hypothermic < 95.9 ⁰F

Nursing Management of Myxedema Coma :

Nursing Management of Myxedema Coma Maintain airway/may need ventilator support Maintain circulation Provide continuous EKG monitoring Monitor ABGs Monitor body temp Monitor I/O’s and daily weight Check for possible sources of infection Administer corticosteroids and glucose, as ordered

History & Physical Exam:

History & Physical Exam

Laboratory Findings & Imaging:

Laboratory Findings & Imaging Emergency Basis Low T3/4, High TSH (primary) Enlarged heart ECG: bradycardia , low QRS, flattened/inversed T, conduction abnormalities

Treatment:

Treatment Stabilization. Fluids , Electrolytes . Mech. Ventilation. Corticosteroids +Thyroid Hormone replacement- Levothyroxin . Hypothermia, Regular Blankets. Medications. Other precipitating factors. Hospitalization – ICU for all!