Thyrotoxicosis is gaining recognition as a significant clinical problem in the elderly. However, distinguishing thyrotoxicosis is difficult because the elderly usually present with nonspecific and atypical clinical manifestations. The most common cause of hyperthyroidism in the elderly is toxic multinodular goiter. The second most common cause is diffuse toxic goiter (Graves’ disease). With the elderly thyrotoxic patient, cardiovascular clinical manifestations usually predominate. The elderly frequently have palpitations, tachycardia, atrial fibrillation, and congestive heart failure. Atrial fibrillation and congestive heart failure are resistant to conventional cardiac glycoside therapy. The elderly may be treated with thioureas, beta-blockers, and when they are euthyroid, radioactive iodine. At risk for thyroid storm, the elderly thyrotoxic patient must be monitored carefully for predisposing factors; especially respiratory infections. Treatment for thyroid storm includes recognition and elimination of the precipitating factor(s); control of fever, if present; thioureas (antithyroid medications); beta-blockers, and sodium iodine
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1 February 1992
Critical Care of the Elderly|
February 01 1992
The Elderly and Thyrotoxicosis
Mary Ellen McMorrow, RN, EdD, CCRN
From the Department of Nursing, College of Staten Island, New York.
Reprint requests to Mary Ellen McMorrow, RN, EdD, CCRN, 204 Gates Ave., Jersey City, NJ 07305.
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AACN Adv Crit Care (1992) 3 (1): 114–119.
Citation
Mary Ellen McMorrow; The Elderly and Thyrotoxicosis. AACN Adv Crit Care 1 February 1992; 3 (1): 114–119. doi: https://doi.org/10.4037/15597768-1992-1014
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