Myxedema coma NCLEX review notes for students who are prepping to take the NCLEX exam. The endocrine system is made-up of many complications, such as myxedema coma which is caused by untreated hypothyroidism.
As a student prepping for NCLEX, it is very important you know the details about myxedema coma and how to care for a patient experiencing this condition.
As the nurse taking care of a patient in myxedema coma, it is important you understand the signs and symptoms, pathophysiology, causes, nursing interventions, and medical treatments.
This NCLEX review is part of an endocrine series of thyroid disorders.
Don’t forget to take the quiz on myxedema coma.
In this NCLEX review, you will learn the following:
-Signs and symptoms of myxedema coma
-Causes of myxedema coma
-Medications for myxedema coma
Lecture on Myxedema Coma
Definition: life-threatening condition that occurs in patients with hypothyroidism due to severely low thyroid hormones (untreated or undiagnosed hypothyroidism).
Causes of Myxedema Coma
Occurs mainly in elderly women with hypothyroidism who have experienced:
- illness (respiratory or urinary infection)
- stressful event (MI)
- medications (Lithium: inhibits thyroid hormone release) or sedatives
- toxicity of antithyroid medications…used to treat hyperthyroidism
- not taking thyroid replacement medications (some patient will abruptly stop them because they think they are not helping…medications take a while to see effects)
- Thyroidectomy (removal of the thyroid gland)
Signs and Symptoms of Myxedema Coma
Patients will have the typical HYPOTHYROIDISM signs and symptoms, BUT they will be more SEVERE….systems of the body are slowing down to the point of death
- Hypothermia (not just cold intolerance)
- Myxedema: swelling of tissues that have a waxy appearance or orange peel texture which will be located on the eyes and face
- Slow heart rate and low blood pressure
- Respiratory failure (most likely will need mechanical ventilation)
- Hyponatremia (due to the increased antidiuretic hormone which causes the body to conserve water & decreased glomerular filtration rate because there is decreased blood flow to the kidneys)
- Hypoglycemia (due to the reduced metabolic rate hence decreased gluconeogenesis)
- Very confused/drowsy…may progress to a coma
Nursing Interventions for Myxedema Coma
- Monitor HR, BP, EKG, temperature, respiratory status (respiratory failure and maintain airway)
- Administer IV solutions as prescribed (ex: normal saline or hypertonic solutions…to correct hyponatremia and correct cardiovascular collapse) Learn more about isotonic, hypotonic, and hypertonic solutions
- IV thyroid hormones: Synthroid (this can cause adrenal insufficiency because thyroid hormones increase the metabolic clearance of glucocorticoids….so corticosteroids may be prescribed along with treatment)
- ****Watch for signs and symptoms of Synthroid toxicity which would present as signs and symptoms of hyperthyroidism (fast heart, feeling hot, sweating)
- Administered glucose IV for hypoglycemia
- Keep patient warm with warming blankets as prescribed
- NO sedatives or narcotics for these patients….very sensitive to them
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