A patient with hypothyroidism is three days post-operative knee replacement when the patient becomes confused with marked hypothermia, and myxedema coma is suspected. What immediate actions should the nurse include?

Administer IV thyroxine as prescribed.
Give oxygen therapy.
Replace fluids intravenously.


• Myxedema coma is a medical emergency caused by severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related to slowing of function in multiple organs.

• Supportive measures for the management of myxedema coma must begin immediately and include maintaining a patent airway, giving oxygen, administering intravenous fluids including electrolytes and glucose, and IV administration of thyroid hormone as prescribed.

• The use of hypothermia blankets, sodium iodide, and beta blockers are more commonly associated with hyperthyroidism. High fever is seen in thyroid storm and is treated with hypothermia blankets. Thyroid storm or thyrotoxicosis is a complication of hyperthyroidism.

• Beta blockers are given to decrease the effects of sympathetic nervous system stimulation and to treat tachycardia in a client who has thyrotoxicosis, a complication of hyperthyroidism.

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