TUTORIAL SCENARIO - THYROIDECTOMY

Mrs Jemma James, aged 46 years just returned to the surgical ward from the Recovery Room following a
complete thyroidectomy. Information in her file reveals that Mrs James gave a history of multiple thyroid
nodules increasing in size and number after having been monitored for a period of about 1 year.

Questions

1. What are other indications for a thyroidectomy?

2. What would be the common clinical manifestations of hyperthyroidism

3. What would be some of the diagnostic tests that Mrs James would have done to confirm the
diagnosis prior to surgery

Surgery was uneventful and in the Recovery Room, the patient had a normal blood pressure (120-130/75-
80). On arrival to the ward she was drowsy but oriented to time, person, place. She complained of pain at
the operative site, rated at 8 on a scale of 1 to 10. The pulse oximeter showed a tachycardia at a rate of
116/minute and an oxygen saturation of 98%. Her blood pressure was 122/68 mmHg; respiratory rate was
22/minute and her chest was clear bilaterally. Her temperature was 98.4 degrees F. An IV infusion of 5%
dextrose and .45% normal saline was infusing at a rate of 125 ml per hour.

4. Describe the initial focussed assessment the nurse would do for Mrs James on return to the ward

5. What are possible complications that the nurse should observe for in the immediate post-op
period

6. Describe the priority nursing management of Mrs James for the first 24 hours post-operatively

7. Identify 3 important areas for patient teaching in preparation for discharge planning.