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Symptom: Heat or Cold Intolerance

Initial Grading Reminder

CTCAE Grading of Heat/Cold Intolerance:

Grade 2: Symptomatic; thyroid replacement indicated; limiting instrumental ADLs

Assessment and Grading

Characterize the symptom (onset, pace)

Ask the patient:

Is this a new or worsening symptom? When did it start or get worse? Has it developed gradually or suddenly?

Grade the symptom

Ask the patient:

How much difficulty do you have with the heat? With the cold? Is it affecting your ability to function? Are you able to sleep?

Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Are you having any difficulty swallowing? Do you feel like your heart is going real slow or real fast? Do you feel like yourself mentally (i.e., are you a bit hyper or depressed)?

Patient Factors to Consider That Affect the Approach to Intervention

Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?

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    Suggested Intervention

    Patients who are affected by the temperature intolerance should be seen.

    Patients with any of the red-flag symptoms should be seen immediately.

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    Nursing Assessment of Potential Causes

    [tab category='Thyroiditis' header="Thyroiditis - Nursing Assessment" tab1='Look' tab2='Listen' tab3='Recognize']

    Differential Diagnosis

    What do you suspect is the cause of your heat/cold intolerance?

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