Severe Hypothyroidism: Introduction to Myxedema Coma (Nursing)

00:01 Myxedema coma is one of the worst complications of severe hypothyroidism, so I want to walk you through this and break it down for you.

00:10 Myxedema coma is this really strange word, but it is life threatening for someone with hypothyroidism.

00:17 Now again, this is a severe, life threatening experience for somebody with hypothyroidism. Now it can be caused by primary causes or there's some other triggering factors.

00:29 So primary causes you're not likely to see.

00:32 But this would be someone who has severe hypothyroidism.

00:36 Maybe they were unaware of it.

00:37 They've had it a long time.

00:39 Or maybe they refuse their treatment, and then they begin to decompensate and it puts them into a life threatening situation called myxedema coma.

00:48 But there are some other triggers that you're more likely to experience with your clients.

00:52 These would be things that like push someone with severe hypothyroidism into the experience of a myxedema coma.

00:58 Now, the most common trigger is infections, so clients with hypothyroidism need to be aware that they need to do more monitoring when they have an infection and keep a good conversation going with their health care providers.

01:10 Also, stress there's other major stressors that could cause someone to go into an experience of a myxedema coma.

01:17 And third, there's some medication related things that can cause a myxedema coma. So primary they have severe hypothyroidism.

01:26 It isn't treated, or they stop their treatment and they can end up in a myxedema coma for triggering factors that you want to keep in mind.

01:34 Infections, which is the most common major stress in their life, or there's some medications that can also set that off.

01:41 So let's look at what type of infections can be a triggering factor.

01:45 Some of the most common ones would be like pneumonia, a UTI and definitely sepsis.

01:51 So if you have a client with sepsis and a diagnosis of hypothyroidism, you're going to be on high alert.

01:57 So the first one was infections.

01:58 The second one are other major stressors.

02:00 And let me give you some examples of what those are.

02:03 Exposure to extreme cold.

02:05 The patient may have trauma or surgery may experience heart failure stroke or medications like sedatives, narcotics and anesthesia.

02:14 So these are factors you want to keep in mind.

02:17 If your patient has a diagnosis of hypothyroidism.

02:20 They're aware of what these major stressors could be.

02:23 And you're aware if you're caring for a client that has hypothyroidism.

02:27 Now finally, we're talking about medication-related triggering factors that could cause myxedema coma.

02:34 Say the patient decides to stop their thyroid replacement medication that could throw them into a myxedema coma.

02:40 And last, certain drugs will affect the thyroid function.

02:44 Things like lithium or amiodarone.

02:47 So keep that in mind. Those are other medication related factors that could trigger a myxedema coma. Now, this coma is considered a medical emergency and it requires immediate intensive care treatment.

02:59 Right. You need to be in intensive care with thyroid hormone replacement and supportive care. If the client doesn't get treatment, Myxedema coma has a very high mortality rate, so keep that in mind that you know the triggers, the primary reasons, and what needs you need to do to respond to a severe emergency.