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NURSING CARE PLAN FOR A PATIENT WITH POST SUB-TOTAL/TOTAL THYROIDECTOMY…
NURSING CARE PLAN FOR A PATIENT WITH POST SUB-TOTAL/TOTAL THYROIDECTOMY
DEFINATION
Thyroidectomy Is the surgical removal of the thyroid gland.
POTENTIAL FOR AIRWAY OBSTRUCTION
NURSING DIAGNOSIS
Risk of altered air entry related to neck oedema secondary to surgery
EXPECTED OUTCOME: Airway should remain clear with no strain on he suture line.
NURSING INTERVENTION AND RATIONALE
nurse patient in fowler's position to facilitate breathing and reduce neck swelling
support head between two sandbags to reduce strain on the sutures.
Keep clip removal set at the bedside in case of an emergency
EVALUATION: There must be no signs of airway obstruction on return from surgery.
BLEEDING:
NURSING DIAGGNOSIS:
risk for bleeding and heamatoma in neck following surgery.
EXPECYED OUTCOME: To detect and manage bleeding early.
NURSING INTERVENTION AND RATIONALE
Monitor vital sign freaqeuntly
Observe for obvious bleeding from the wound.
Be alert for signs of laboured breathing and or strodor which may indicate airway obstruction.
Keep suture removal at bed side so that sutures be removed if airway becomes laboured.
cover open wound with sterile gauze that have been soaked in sterine saline and patient should be returned to theatre.
TETANY
NURSING DIAGNOSIS
Risk of tetany related to posible accidental removal of one or more parathyroid glands.
EXPECTED OUTCOME: Calcium concentration in the blood stream normal.
NURSING INTERVENTION AND RATIONALE: Observe the patienryngospasm and airway obstruction.t vlosely for signs of teteny as a sudden drop in bloodcalcium levels may result in lu
An ampule of calcium chloride or gluconate,syrange and needle can be kept at the bedside.
if patient develop teteny,nurse must administer prescribed slowly calciumand observe the response.
reffer patient for immediate medical attention and posible transfer to the intensive care unit.
EVALUATION: There must be no evidence of hypocalcaemia or tetant after 6-8 hours.
RESTLESSNESS,HYPERPYREXIA,ELEVATED BLOOD PRESSURE
Diagnose the risk of thyroid crisis related to handling of thyroid gland and related to hormone into the blood.
No thyroid crisis expected on the outcome.
Monitor vital signs regulary; Half hourly intervals are recomended until the risk of thyroid crisis has pased(24-48 hours).
On evaluation; no evidence of thyroid crisis after 6-8 hours.
LOSS/HOARSENESS OF VOICE
Observe the patient for any dilficuilt in breathing,dysphagia and hoarseness
Keep a tracheostomy set at the bedside incase for an emergency tracheostomy.
No laryngeal nerve damage expacted.
No hoarseness or loss of voice after 6-8 hours
A nurse should diagnose the risk of the recurrent laryngeal nerve