Full Answer
How do you treat tetany in thyroid cancer?
Calcium is used to treat tetany. The client may receive iodine solution (Lugol’s solution) for 10 to 14 days before surgery to decrease vascularity of the thyroid and thus prevent excess bleeding. Lugol’s solution does not potentiate any other preoperative medication.
What medications are used to treat tetany?
Magnesium sulfate 4. Propylthiouracil (PTU) 1. Calcium chloride Calcium chloride or calcium gluconate should be available to treat tetany caused by accidental removal of the parathyroid glands during surgery. The parathyroid glands regulate calcium metabolism. Potassium chloride replaces the electrolyte potassium.
What would be an important nursing intervention after a thyroidectomy?
The nurse is caring for a client postoperative thyroidectomy. What would be an important nursing intervention? 1. Have the client speak every 5 to 10 minutes if hoarseness is present. 2. Provide a low-calcium diet to prevent hypercalcemia. 3. Check the dressing at the back of the neck for bleeding.
What intervention should the experienced certified nursing assistant delegate to hyperthyroidism?
For the patient with hyperthyroidism, what intervention should you delegate to the experienced certified nursing assistant? Instruct the patient to report palpitations, dyspnea, vertigo, pr chest pain. Draw blood for thyroid-stimulating hormone, T3, and T4 levels. Check the apical pulse, blood pressure, and temperature every 4 hours.
How do you manage hypocalcemia after thyroidectomy?
Patients who have symptomatic hypocalcemia in the early postoperative period or whose calcium levels continue to fall rapidly require treatment. In symptomatic patients, replace calcium with intravenous calcium gluconate. Ten milliliters of 10% solution (1 g) may be administered over 10 minutes.
What should be kept at the bedside of a client who has just had a thyroidectomy?
After surgery, keep the patient in high-Fowler's position to help prevent any excess edema from forming and to minimize bleeding or oozing from the incision. Patients experiencing hypocalcemia will receive calcium gluconate. Pain medication and/or ice pack to the affected area as needed.
What do you monitor after thyroidectomy?
It is important to monitor both calcium and magnesium levels after total thyroidectomy and to correct deficiencies to facilitate prompt resolution of symptoms.
What kind of calcium should I take after a thyroidectomy?
Every total thyroidectomy patient or completion thyroidectomy patient is started on 3 grams of elemental calcium, p.o., per day. This should begin as soon as the patient can take p.o. unless there is a specific contraindication to oral calcium in the patient. Check ionized calcium q8 hours post-op.
Which of the following nursing interventions is appropriate after a total thyroidectomy?
Thyroidectomy requires meticulous postoperative nursing care to prevent complications....Desired Outcomes.Nursing InterventionsRationalePlace in semi-Fowler's position and support head and neck with sandbags or small pillows.Prevents hyperextension of the neck and protects the integrity of the suture line.7 more rows•Mar 18, 2022
What is the management of thyroidectomy?
If you need only part of your thyroid removed (partial thyroidectomy), your thyroid may work normally after surgery. If your entire thyroid is removed (total thyroidectomy), you need daily treatment with thyroid hormone to replace your thyroid's natural function.
What is the most important complication to monitor when caring for a patient after thyroidectomy?
Hypocalcemia is the most frequent, symptomatic or asymptomatic, rebleeding with hematoma, laryngeal nerve injury, acute pain or infection as the most important. There is a series of care that favors the early detection of these and other things.
What is the complication of thyroidectomy?
Major postoperative complications include wound infection, bleeding, airway obstruction (compressing hematoma, tracheomalacia), hypocalcemia, thyroid storm (uncommon, usually associated with Grave's disease) and recurrent laryngeal nerve injury.
Why is calcium gluconate given after thyroidectomy?
To protect against the development of symptomatic hypocalcemia that occurs with postoperative hypoparathyroidism, many medical centers routinely discharge patients who have undergone thyroidectomy with prescriptions for calcium supplementation.
What causes tetany and laryngeal spasms in thyroidectomy?
This spasm is due to increased excitability of peripheral nerves.
Why is calcium low after thyroidectomy?
Low blood calcium is usually caused by poor parathyroid gland function called hypoparathyroidism. Hypoparathyroidism is usually caused by the removal of parathyroid glands during surgery for the thyroid or parathyroid.
What happens to calcitonin after total thyroidectomy?
Calcitonin levels fell in all patients after surgery. The average calcitonin decrease was 44% at 10 minutes after surgery and 61% at 30 minutes after surgery. The calcitonin decreased greater than 50% at 30 minutes after surgery in all 16 patients who no evidence of persistent cancer.
Why does gigantism-giantism occur only in children?
- Occurs before epiphyses close - Pituitary disorder --> excess secretion of GH - Benign tumor (IGF-1 in liver) - Increased growth of bone and tissue
What causes acromegaly?
- Excessive GH secretion after closure of epiphyses of long bones - Often result of benign slow-growing tumor (pituitary adenoma)
Graves disease—would you expect the TSH level to be high or low? Physical assessment findings.
- (Hyperthyroidism) - TSH high - ** Exophthalmos (bulging of eyes) - Fatiguability, hypertension, shortness of breath, tachycardia, nervousness, di...
Signs of thyroid storm/crisis
- Elevated temperature - Tachycardia, arrhythmias - Agitation, tremors, anxiety, restlessness - Delirium - Confusion and seizures as condition prog...
Clinical manifestations of hypothyroidism (common & less common ones). Be able to select the correct combination of S/S
- Intolerance to cold - Weight gain - Myxedema (facial swelling) - Constipation & abdominal distention - Tongue enlarged, voice hoarse/husky - Carp...
Dangerous complication influencing the parathyroid glands after thyroidectomy
- Check calcium levels and assess for tetany (will happen if calcium is low) because parathyroid may have been damaged or accidentally removed - Pe...
Be able to match Cushing disease with its clinical manifestations in a multiple choice question
- Buffalo hump - Moon face - Truncal obesity, thin extremities - Thin skin, purple striae - Muscle weakness, osteoporosis - Hyperglycemia, glucose...
What are the general s/s of diabetes insipidus?
- Excessive thirst and large amounts of diluted urine most characteristic - Hypernatremia due to water deficit - Low urine specific gravity - Dehyr...
Neurogenic diabetes insipidus—be able to recognize the clinical manifestations
- Deficiency in ADH secretion related to head trauma, brain surgery, genetics, tumors - Less ADH than nephrogenic DI
What is the best treatment for tetany caused by accidental removal of the parathyroid glands?
Calcium chloride. Calcium chloride or calcium gluconate should be available to treat tetany caused by accidental removal of the parathyroid glands during surgery. The parathyroid glands regulate calcium metabolism. Potassium chloride replaces the electrolyte potassium.
Where to check calcium levels after parathyroid surgery?
Check the dressing at the back of the neck for bleeding. If bleeding occurs, the blood will drain posteriorly or behind the client's neck. Serum levels of calcium are important to monitor because of possible damage to the parathyroids during surgery. Oral intake of calcium is not immediately significant.
What causes fluid in the retro orbital tissues?
Fluid in the retro-orbital tissues that increases pressure behind the eyes. Impaired venous drainage from the orbit of the eye causes fluid and fat accumulation in the areas behind (retro-orbital) the eyeballs, which forces the eyes forward and out of their sockets.
Can adrenalectomy cause hypertension?
An excess of these catecholamines can cause severe hypertension. Surgery (an adrenalectomy) alleviates the elevated blood pressure most of the time. In 10% to 30% of clients, hypertension remains and must be monitored and treated. Electrolytes imbalances and blood sugar are not typically affected.
What to take after a thyroidectomy?
After a total thyroidectomy, the patient will need to be instructed to take exogenous thyroid hormone for life (levothyroxine). This medication must be taken on an empty stomach, typically first thing in the morning. You can read more about thyroid replacement medication here.
What to do if a patient has parathyroid damage?
If the patient has parathyroid damage, instruct him that he will need to take calcium supplements and how to recognize signs of hypocalcemia. So there you have it. Your down and dirty guide to taking care of patients undergoing thyroidectomy using the Straight A Nursing LATTE method.
Why do people have thyroids removed?
One of the most common reasons a patient may have their thyroid removed is because of thyroid cancer, but can also be due to the presence of nodules on the thyroid, go iter or hyperthyroidism (which you can read about here ). In the old-old days, a thyroidectomy was a dangerous surgery with a lot of risks, but improvements in surgical technique have ...
What is the most common complication of thyroidectomy?
Another common complication of thyroidectomy is hypocalcemia due to damage inflicted on the parathyroid gland. Think about the signs/symptoms of hypocalcemia and base your assessments on that.
What to expect during partial thyroidectomy?
If partial thyroidectomy, anticipate collecting blood for thyroid hormone levels. Prior to surgery for hyperthyroidism, the patient will likely be taking medications to help prevent thyroid storm during/after the procedure. These patients will need thyroid levels checked prior to surgery.
How long should you keep a tracheostomy tray?
Many hospitals have a protocol of keeping a tracheostomy tray at the bedside for the first 24-hours after surgery, just in case. Hopefully you won’t ever need it.
What are the signs of hypothyroidism?
Patients should also be instructed to monitor themselves for signs of hypothyroidism which can include: lethargy, brain fog, hair loss, weight gain, hoarse voice, and others. They should also be aware of signs of hyperthyroidism, which typically include tachycardia, anxiety, restlessness.
What happens to the body when you have hyperthyroidism?
In the client with hyperthyroidism, excessive thyroid hormone production leads to hypermetabolism and increased nutrient metabolism. These conditions may result in a negative nitrogen balance, increased protein synthesis and breakdown, decreased glucose tolerance, and fat mobilization and depletion.
Does Lugol's solution prevent tetany?
Lugol’s solution does not act to prevent tetany. Calcium is used to treat tetany. The client may receive iodine solution (Lugol’s solution) for 10 to 14 days before surgery to decrease vascularity of the thyroid and thus prevent excess bleeding. Lugol’s solution does not potentiate any other preoperative medication.
What is thyroid storm?
Thyroid storm is a life-threatening condition in which patients with underling thyroid dysfunction inhibit exaggerated signs and symptoms of hyperthyroidism. Thyroid storm is precipitated by stressors such as infection, trauma, DKA, surgery, heart failure, or stroke. The condition can result from discontinuation ...
What is the immediate priority for postoperative care?
Upon assessment, the immediate priority that the nurse would include is: Though fluid volume status, neurological status and pain are all important assessment, the immediate priority for postoperative is the airway management. Respiratory distress may result from hemorrhage, edema, laryngeal damage or tetany.
How to help a hypermetabolic patient?
Encourage patient to eat and increase number of meals and snacks. Give or suggest high-calorie foods that are easily digested. Rationale: Aids in keeping caloric intake high enough to keep up with rapid expenditure of calories caused by hypermetabolic state. Provide a balance diet, with six meals per day.
What happens to the body when you have hyperthyroidism?
In the client with hyperthyroidism, excessive thyroid hormone production leads to hypermetabolism and increased nutrient metabolism. These conditions may result in a negative nitrogen balance, increased protein synthesis and breakdown, decreased glucose tolerance, and fat mobilization and depletion.
What to do when you are awake and taping your eyelids shut?
Encourage use of dark glasses when awake and taping the eyelids shut during sleep as needed. Suggest use of sunglasses or eyepatch. Moisten conjunctiva often with isotonic eye drops.#N#Rationale: Protects exposed cornea if patient is unable to close eyelids completely because of edema or fibrosis of fat pads and/or exophthalmos.
What does it mean when TSH levels increase after 30 minutes?
An increase in the TSH level after 30 minutes during the TSH stimulation test. Question 1 Explanation: In the TSH test, failure of the TSH level to rise after 30 minutes confirms hyperthyroidism. A decreased TSH level indicates a pituitary deficiency of this hormone.
Can you have a thyroid storm while pregnant?
In addition to the above-mentioned complications of uncontrolled hyperthyroidism in pregnancy, expectant mothers may suffer congestive heart failure and thyroid storm, which is life-threatening thyrotoxicosis with symptoms that include agitation, confusion, tachycardia, shaking, sweating, diarrhea, fever, and restlessness.