In managing a patient experiencing thyroid storm, which of the following interventions should the nurse prioritize? Select all that apply.

Rationale: A. During thyroid storm, patients are critically ill with severe tachycardia, fever, dehydration, and possible cardiac compromise. Encouraging ambulation at this stage can worsen cardiovascular stress, fatigue, and oxygen consumption, potentially precipitating complications such as arrhythmias or heart failure. Ambulation is deferred until the patient is hemodynamically stable. B. Thyroid storm significantly increases the metabolic rate and oxygen demand. Patients may develop tachypnea and hypoxia if oxygen delivery is inadequate. Administering supplemental oxygen ensures that tissues receive sufficient oxygen, prevents hypoxia-related complications, and supports organ function during the acute crisis. C. Antithyroid medications such as propylthiouracil (PTU) or methimazole inhibit thyroid hormone synthesis, which is the underlying cause of thyroid storm. Prompt administration is essential to reduce circulating thyroid hormone levels and mitigate the risk of cardiovascular collapse, hyperthermia, and multi-organ failure. PTU also inhibits the peripheral conversion of T4 to T3, which is particularly beneficial in acute crises. D. Thyroidectomy is not an immediate intervention during thyroid storm because surgery carries a high risk of mortality and exacerbation of the storm in an unstable patient. Definitive surgery is considered only after stabilization with medications and supportive care. E. While patient education is essential for long-term management, it is not a priority during an acute thyroid storm. The immediate focus is on life-saving interventions and stabilization. Education can be provided after the patient is stable and able to participate safely. F. Thyroid storm often causes severe tachycardia, hypertension, and hyperthermia, which increase cardiac workload and risk of arrhythmias. Beta-blockers, particularly propranolol, reduce heart rate, control blood pressure, and limit peripheral effects of thyroid hormones, making them a critical component of acute management. G. Frequent assessment of vital signs, cardiac rhythm, fluid status, electrolytes, and thyroid hormone levels is essential during thyroid storm. Continuous monitoring allows for early detection of deterioration, rapid intervention, and adjustment of medications, ensuring patient safety and improving outcomes. H. Patients with thyroid storm often experience dehydration due to hypermetabolism, excessive sweating, vomiting, and tachypnea. IV fluids help restore circulating volume, maintain hemodynamic stability, support renal perfusion, and correct electrolyte imbalances, which are vital in preventing shock or organ dysfunction.