Tetany.-The nurse must be alert and keenly observant to detect any symp-toms of tetany, such as stiffness and pain- May require ligation of bleeding vessels. Abstract. The thyroidectomy patient – nursing considerations. Place in semi-Fowler’s position and support head/neck with sandbags or small pillows. You have entered an incorrect email address! Administer Lugol’s solution, anti-thyroid drugs such as Methimazole or Propythiouracil, and cardiac drugs such as propranolol. Nursing Diagnosis: Airway Clearance, risk for ineffective, Nursing Diagnosis: Communication, impaired verbal, Nursing Diagnosis: Injury, risk for [tetany], Nursing Diagnosis: Knowledge, deficient [Learning Need] regarding condition, prognosis, treatment, self-care, and discharge needs. Reduces pain and discomfort; enhances rest. Impaired articulation, does not/cannot speak; use of nonverbal cues such as gestures, Surgical interruption/manipulation of tissues/muscles, Narrowed focus; guarding behavior; restlessness, Lack of exposure/recall, misinterpretation, Questions; request for information; statement of misconception, Inaccurate follow-through of instructions/development of preventable complications. If a total thyroidectomy is performed, rarely both the left and right recurrent laryngeal nerves may not work, and the patient may have trouble breathing. Note widened pulse pressure. Visit patient frequently. Hoarseness and sore throat may occur secondary to tissue edema or surgical damage to recurrent laryngeal nerve and may last several days. Near- total Thyroidectomy: This is the complete removal of one thyroid lobe and a near-total lobectomy on the contralateral side. Objective: Patient/family will verbalize understanding of routine preoperative instructions. Maximizes supply and absorption of calcium if parathyroid function is impaired. This may require a breathing tube to be placed … Demonstrate use of relaxation skills and diversional activities appropriate to situation. NCP Thyroidectomy. Covers the incision without aggravating healing or precipitating infections of suture line. © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! Rheumatoid Arthritis [Actual Diagnoses] Nursing Care Plan, Pneumonia Nursing Care Plan and 7 Common Risk Diagnoses [Updates], Nursing Care Plan for Patients Undergoing Hemodialysis [Risk Diagnoses], Patients Suffering from Burns Nursing Care Plan [Actual and Risk Diagnoses], Nursing Care Plan for Patients with Hypertension [Actual and Risk Diagnoses], Cancer Nursing Care Plan and NANDA Guidelines [Updates], How Nurses Cope with Their Mental Health During the COVID Crisis, Patient Care with Mental Health Disorders, NCLEX-RN Psychiatric Nursing Practice [ Mock Test Set 2], Bullying in the Workplace: How Nurses Can Cope. Prevents hyperextension of the neck and protects the integrity of the suture line. Limits stretching, muscle strain in operative area. Hemorrhage- a tension hematoma could be due to the slipping of a ligature on the superior thyroid artery. Manipulation of gland during subtotal thyroidectomy may result in increased hormone release, causing thyroid storm. Recommend avoidance of goitrogenic foods, e.g., excessive ingestion of seafood, soybeans, turnips. Suction mouth and trachea as indicated, noting color and characteristics of sputum. There are two main types of thyroidectomy; A total thyroidectomy (complete removal of the gland), or a sub-total thyroidectomy (partial removal). Decrease stress by explaining interventions and teaching relaxation procedures. Psychological distress is considered common mental illnesses and it has been reported that the patients who suffer psychological distress have poor clinical outcomes than the patients without psychosocial disorder. Reduces likelihood of tension on surgical wound. Risk of … Compromised airway may create a life-threatening situation requiring emergency procedure. Thus, an occasional hemorrhage from a thyroid remnant or thyroid vein could be possible. Although both may be soothing to sore throat, soft foods may be tolerated better than liquids if patient experiences difficulty swallowing. Contraindicated after partial thyroidectomy because these foods inhibit thyroid activity. Useful in evaluating pain, choice of interventions, effectiveness of therapy. Ineffective airway clearance related to airway obstruction (airway spasm). Thyroidectomy has been considered an effective method to treat thyroid cancer. Search for more papers by this author. 3. Place in semi-Fowler’s position and support head and neck with sandbags or small pillows. Nursing Interventions for Thyroid Storm Monitor HR, BP, RR (respiratory failure…may need mechanical ventilation), EKG, Temperature Keep environment quiet and patient cool (cooling blankets and sedatives as prescribed) No foods containing iodine (seafood…seaweed, dairy, eggs) The intake of medications and the solution would brought about a decrease in the vascularity of the thyroid gland in 2 to 3 weeks and would also prevent postoperative hemorrhage. 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A physically comfortable and psychologically calm … No: restlessness, cyanosis, and dyspnea. 4. Nursing Interventions. Thyroidectomy/ Parathyroidectomy Post-Operative Instructions - 2 - o You may also use a heating pad on the affected areas for 15-20 minutes at a time several times a day. #1_InterventionReview lab Ca+ levels as soon as received from lab for ↓ blood Ca+ as ordered by the MD. Keep call bell and frequently needed items within easy reach. Includes patient positioning, assessment of bleeding, and assessment for signs/symptoms of parathyroid damage (i.e. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Thyroid storm is considered an emergency case for it can cause heart failure and lead to death. hemorrhage during and after surgery). Trousseau’s sign (taking blood pressure while noting for spasm of the wrist). Plan appropriate nursing assessments and interventions for the patient who might experience complications of a thyroidectomy. Nursing interventions for potential complications after thyroidectomy. Hyperthermia is the earliest sign of thyroid storm. Stitch Granuloma – this complication may happen with or without sinus formation and is seen after the use of a non-absorbable suture material. If thyroid hormone replacement is needed because of surgical removal of gland, patient needs to understand rationale for replacement therapy and consequences of failure to routinely take. Hypocalcemia with tetany (usually transient) may occur 1–7 days postoperatively and indicates hypoparathyroidism, which can occur as a result of inadvertent trauma to/partial-to-total removal of parathyroid gland(s) during surgery. 2.21.2007. Prevention of complications and nursing care in post-surgical management. What are the most important nursing interventions for this client? Nurseslabs.com is an education and nursing lifestyle website geared towards helping student nurses and registered nurses with knowledge for the progression and empowerment of their nursing careers. Useful in evaluating pain, choice of interventions, the effectiveness of therapy. We also use third-party cookies that help us analyze and understand how you use this website. Review drug therapy and the necessity of continuing even when feeling well. Limit the patient movement by providing sandbags at the side or side pillows. Nursing Interventions Rationale; Assess verbal and nonverbal reports of pain, noting location, intensity (0–10 scale), and duration. Expected outcomes: Demonstrate effective airway clearance evidenced by gas exchange and ventilation harmless. Check dressing frequently, especially posterior portion. Instruct patient to use hands to support the neck during movement and to avoid hyperextension of the neck. Respiratory Obstruction – this is rarely due to the collapse or kicking of the trachea. Keep communication simple; ask yes/no questions. In patients with subtotal thyroidectomy, exercise can stimulate the thyroid gland and production of hormones, facilitating recovery of general well-being. Laura Daniels RVN MBVNA. Softens tissues and may help minimize scarring. Thyroidectomy requires meticulous postoperative nursing care to prevent complications. May indicate edema/sequestered bleeding in tissues surrounding operative site. Chemical imbalance: excessive CNS stimulation. Early recognition of developing complications such as infection, hyperthyroidism, or hypothyroidism may prevent progression to life-threatening situation. Recommend the use of loose-fitting scarves to cover scar, avoiding the use of jewelry. Therapeutic Communication Techniques Quiz. Caution patient to avoid bending neck; support head with pillows. Provide alternative methods of communication as appropriate, e.g., slate board, letter/picture board. Establish method of communication in which needs can be understood. Compare and contrast the symptoms of hypoparathyroidism with hyperparathyroidism. Nursing Diagnosis and Interventions for Thyroidectomy - Postoperative 1. During operation, it is very important to protect the parathyroid glands from damage or removal during the surgical procedure, and to also prevent damage to the recurrent laryngeal nerves.
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