2. THYROIDECTOMY
• Removal of all or part of thyroid gland is called thyroidectomy.
• Indication:
- Thyroid Cancer
- Non-cancerous enlargement of thyroid
- Hyperthyroidism
- Undeterminate thyroid nodules
• Nursing Management:
* Assessment:
- Monitor vital signs
-Assess verbal and nonverbal response reports of pain, noting location , intensity (0-
10 scale) duration.
-Monitor respiratory rate , depth and work of breathing
-Assess breath sounds
- Assess speech
- Assess the neuromuscular irritability (twitching,numbness, seizure activity)
- Assess the swallow
3.
4. • Nursing diagnosis:
(1) Acute pain related to surgical incision in neck.
(2) Impaired airway related to tissue swelling of neck
(3) Impaired swallowing related to surgical incision in front of neck
(4) Risk for impaired verbal communication related to discomfort , tissue edema
in neck
(5) Anxiety related to prognosis of disease
(6) Risk for injury related to excessive CNS stimulation due to hypocalcemia
• Nursing Intervention:
(a) Pain Management :
-Place in semi-flowers position and support head and necks with sandbags or
small pilllows.
- Keep call bell and frequently needed items within the bedside or easy reach
- Maintain head and neck in neutral position and support during position
changes. Instruct patient to use hand to support neck during movement and
avoid hyperextension of neck.
- Give cool liquids or soft foods, such as icecream
- Encourage patient to use relaxation techniques like soft music
- Administer analgesic
- Provide ice collar if indicated
5. (b) Airway clearance :
- Suction mouth and treachea ( observe the color of secretion , any clots etc)
- Provide steam inhalation: humidify room air
- Keep tracheostomy tray at bedside ( there may be compromised airway
which may cause respiratory distress )
(c) Verbal communication:
- Voice rest ; keep simple communication of yes or no
- Maintain quiet environment
- Provide alternative methods of communication like paper pen for writing ,
picture board etc
- Visit patient freqently or keep bell
(d) Swallowing
- Provide oral care before feeding.
- Encourage voice rest
- Place suction equipment at bedside for suctioning periodically
- Place semi- flower’s position for feeding
- Give small amount of meals and encourage to eat slowly.
6. • Injury:
-Keep siderails, bed in lower position .
- Avoid use of restraints
- Monitor serum calcium levels (<7.5mg is hypocalcemia which may require
replacement therapy too )
- sedatives ( indicated for seizures but it is contraindicated in repiratory
ditress , tracheostomy )
• Discharge Teaching:
- Take medicine timely
- Get plently of rest
- Avoid heavy lifting and strenous activity for 3 to 5 weeks
- Take soft and cold meal
When to seek medical help
- High fever
- Swelling or bleeding from incision site
-Trouble breathing
- A sore throat last longer than 7 days may indicate or risk of largngeal
nerve damge
- Tinging or cramps in your feet , hands or lips
