Question

Surgery Assignment

A 25-year-old female client is being admitted to the postanaesthetic care unit (PACU) following a thyroidectomy for hyperthyroidism. The client had undergone three months of preoperative treatment with antithyroid medications and iodine preparations to establish euthyroid status prior to her surgery. At the client's bedside the nurse has set up a tracheostomy set, endotracheal tube, laryngoscope, and suction equipment. There are ampules of calcium gluconate on hand. The nurse places the client in a semi-Fowler's position and is supporting her head and neck with pillows and sandbags. The nurse frequently checks the client's vital signs and assesses her suture line for strain or bleeding. Once the immediate postoperative period has passed, the client will be transferred to the surgical ward where she will recuperate and learn about lifelong thyroid replacement therapy.

1. Why is it so important for the client to be euthyroid prior to thyroidectomy?
2. Why is it mandatory to have emergency equipment and ampoules of calcium gluconate on hand following thyroidectomy?
3. Why is it important to support the client's head and neck with sandbags and pillows?
4. Develop a plan of care for this patient two (2) actual and two (2) potential

Answer 1

A.In order to avoid thyrotoxic crisis (thyroid storm), preoperative planning to make the patient euthyroid is necessary. Using a mixture of iopanoic acid, dexamethasone, beta-blockers, and thioamides, the hyperthyroid state can be quickly reversed.

b. If anyone undergoes complete thyroidectomy (removal of the entire thyroid gland), you will need to take calcium supplements after the surgery to avoid a complication called hypocalcemia (low blood calcium levels).

C.Place sandbags or small pillows in the semi-Fowler position and protect the head and neck. Hyperextension of the neck is prevented and the integrity of the suture line is preserved.

D.

1.Swallowing and diet: For several weeks after surgery, can experience some pain while swallowing, which typically resolves with time. In the beginning, consume soft foods, then progress to a regular diet.

2.Pain medication: For the first postoperative week, moderate pain and discomfort is expected. As a pain reliever, you will be given Tylenol with codeine.

3.Thyroid medicine: the person will be put on thyroid replacement medication if a complete thyroidectomy has been performed ( entire thyroid has been removed). By testing TSH level (blood test) at a six-week interval, we can decide if this is the right level.

4.Calcium medication: After a complete thyroidectomy, the amount of calcium will also decrease. Calcium replacement with vitamin D calcium carbonate pills (tums) or vitamin D calcium carbonate (OsCal) is recommended at approximately 6 pills a day. For this drug, do not need a prescription. may be given Rocaltrol, which is a potent preparation for vitamin D.

5.Around 4-5 days after surgery, person can resume normal operation. 2 days after surgery, regular bathing can be resumed. can resume daily routine whenever feel relaxed. Listening to own body and not going outside boundaries is the main determinant.