Thyroidectomy, although rare, may be performed for patients with thyroid cancer, hyperthyroidism, and drug reactions to antithyroid agents; pregnant women who cannot be managed with drugs; patients who do not want radiation therapy; and patients with large goiters who do not respond to anti-thyroid drugs.
The two types of thyroidectomy include:
- Total thyroidectomy: The gland is removed completely. Usually done in the case of malignancy. Thyroid replacement therapy is necessary for life.
- Subtotal thyroidectomy: Up to five-sixths of the gland is removed when antithyroid drugs do not correct hyperthyroidism or RAI therapy is contraindicated.
Nursing Care Plans
Thyroidectomy requires meticulous postoperative nursing care to prevent complications. Nursing priorities will include managing hyperthyroid state preoperatively, relieving pain, providing information about the surgical procedure, prognosis, and treatment needs, and preventing complications.
- Acute Pain
- Risk for Impaired Airway Clearance
- Impaired Verbal Communication
- Risk for Injury
- Deficient Knowledge
May be related to
- Surgical interruption/manipulation of tissues/muscles
- Postoperative edema
Possibly evidenced by
- Reports of pain
- Narrowed focus; guarding behavior; restlessness
- Autonomic responses
- Client will report relief or control of pain.
- Client will demonstrate the use of relaxation skills and diversional activities appropriate to the situation.
|Assess verbal and nonverbal reports of pain, noting location, intensity (0–10 scale), and duration.||Useful in evaluating pain, choice of interventions, the effectiveness of therapy.|
|Place 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.|
|Maintain head and neck in a neutral position and support during position changes. Instruct patient to use hands to support the neck during movement and to avoid hyperextension of the neck.||Prevents stress on the suture line and reduces muscle tension.|
|Keep call bell and frequently needed items within easy reach.||Limits stretching, muscle strain in the operative area.|
|Give cool liquids or soft foods, such as ice cream or popsicles.||Although both may be soothing to sore throat, soft foods may be tolerated better than liquids if patient experiences difficulty swallowing.|
|Encourage patient to use relaxation techniques: guided imagery, soft music, progressive relaxation.||Help refocus attention and assist the patient to manage pain and/or discomfort more effectively.|
|Administer analgesics and/or analgesic throat sprays and lozenges as necessary.||Reduces pain and discomfort; enhances rest.|
|Provide ice collar if indicated.||Reduces tissue edema and decreases the perception of pain.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans related to endocrine system and metabolism disorders:
- Acid-Base Balance
- – Respiratory Acidosis Nursing Care Plan
- – Respiratory Alkalosis Nursing Care Plan
- – Metabolic Acidosis Nursing Care Plan
- – Metabolic Alkalosis Nursing Care Plan
- Addison’s Disease | 3 Care Plans
- Cushing’s Disease | 6 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Diabetes Mellitus Type 2 | 17 Care Plans
- Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) | 4 Care Plans
- Eating Disorders: Anorexia & Bulimia Nervosa | 7 Care Plans
- Fluid and Electrolyte Imbalances | 10 Care Plans
- – Fluid Balance: Hypervolemia & Hypovolemia
- – Potassium (K) Imbalances: Hyperkalemia and Hypokalemia
- – Sodium (Na) Imbalances: Hypernatremia and Hyponatremia
- – Magnesium (Mg) Imbalances: Hypermagnesemia and Hypomagnesemia
- – Calcium (Ca) Imbalances: Hypercalcemia and Hypocalcemia
- Gestational Diabetes Mellitus | 4 Care Plans
- Hyperthyroidism | 7 Care Plans
- Hypothyroidism | 3 Care Plans
- Obesity | 4 Care Plans
- Thyroidectomy | 5 Care Plans