One patient is burning hot and racing; another is cold, slow and barely breathing. Nora connects three original adult cases with thyroid storm, myxedema coma, hormone feedback, medication sequencing, beta-blocker cautions, agranulocytosis, replacement routes and eight rapid recall checks. Learn the bedside clues that turn a thyroid history into an urgent nursing priority.

• Escalate failing vital functions; thyroid hormone levels alone do not establish storm, and myxedema coma need not begin with coma.
• Understand treatment targets and verify sequencing: ATA iodide timing differs from Japanese guidance; IV glucocorticoid coverage precedes IV levothyroxine in myxedema coma.
• Fever or severe sore throat on antithyroid therapy needs urgent evaluation; assess ventilation, perfusion and response throughout emergency care.

Chapters

00:00 Two rooms, two thyroid emergencies

01:00 Your rapid-fire thyroid map

02:06 Hormones, feedback and the lab trap

04:21 The hot patient: recognize the storm

06:16 First minutes: support the patient and the team

07:54 Storm medicines: target, sequence and exceptions

10:30 Fever on methimazole: a different emergency clue

12:19 The cold patient: coma is not required

14:10 Breathing first, not just an oxygen number

16:07 Cold-crisis treatment: route and steroid order

18:02 Prevention: the plan must survive real life

19:38 Eight rapid-fire checks with the why

22:02 The thyroid cue that sticks

Primary sources checked 11 October 2026. Adult scope; current orders, local emergency protocols and the individual endocrine plan control.

• ATA 2016 hyperthyroidism guideline
• JTA/JES 2016 thyroid storm guideline
• ATA 2014 hypothyroidism treatment guideline
• ATA: Hyperthyroidism and antithyroid safety
• DailyMed: Propylthiouracil prescribing information
• Endotext: Adult hypothyroidism

Independent educational content; not affiliated with or endorsed by NCSBN. NCLEX-RN is a registered trademark of NCSBN. Fictional teaching cases and host persona; licensed stock synthetic narration. Use alongside nursing education and current official exam resources. No individual medical advice or exam-result guarantee.

Corrections: ted.lownie@dal.ca