بعد استئصال جزئي للغدة الدرقية بـ ١٠ ساعات: حرارة ٤٠٫١، نبض ١٤٨ غير منتظم، هياج وتعرق. الطبيب وصف بروبيل ثيويوراسيل (PTU) ومحلول اليود. أي ترتيب صحيح للإعطاء؟

Ten hours after a subtotal thyroidectomy the client has T 40.1 °C, an irregular pulse of 148, agitation and diaphoresis. Propylthiouracil (PTU) and iodine solution are prescribed. Which administration sequence is correct?

1. PTU first, then iodine at least 1 hour later
2. Iodine first, then PTU 1 hour later
3. Both at the same time
4. Iodine only, because PTU is contraindicated after surgery

Answer: A) PTU first, then iodine at least 1 hour later. This is thyroid storm. PTU blocks new hormone synthesis, so it is given at least 1 hour before iodine; otherwise iodine becomes substrate for more hormone.