Nursing Care Plan Thyroidectomy

A thyroidectomy is an operation that involves the surgical removal of all or part of the thyroid gland. Surgeons often perform a thyroidectomy when a patient has thyroid cancer or some other condition of the thyroid gland (such as hyperthyroidism). Other indications for surgery include cosmetic (very enlarged thyroid), or symptomatic obstruction (causing difficulties in swallowing or breathing). One of the complications of "thyroidectomy" is voice change and patients are strongly advised to only be operated on by surgeons who protect the voice by using electronic nerve monitoring. Most thyroidectomies are now performed by minimally invasive surgery using a cut in the neck of no more than 2.5 cms(1 inch).

The thyroid produces several hormones, such as thyroxine (T4), triiodothyronine (T3) and calcitonin.

After the removal of a thyroid patients usually take prescribed oral synthetic thyroid hormones to prevent the most serious manifestations of the resultant hypothyroidism.

CARE SETTING

Inpatient acute surgical unit

RELATED CONCERNS

1. Cancer
2. Hyperthyroidism (thyrotoxicosis, Graves’ disease)
3. Psychosocial aspects of care
4. Surgical intervention
5. Patient Assessment Database
6. Refer to CP: Hyperthyroidisim (Thyrotoxicosis, Graves’ Disease), for assessment information.
7. Discharge plan
8. DRG projected mean length of inpatient stay: 2.4 days
9. Refer to section at end of plan for postdischarge considerations.

NURSING PRIORITIES

1. Reverse/manage hyperthyroid state preoperatively.
2. Prevent complications.
3. Relieve pain.
4. Provide information about surgical procedure, prognosis, and treatment needs.

DISCHARGE GOALS

1. Complications prevented/minimized.
2. Pain alleviated.
3. Surgical procedure/prognosis and therapeutic regimen understood.
4. Plan in place to meet needs after discharge.