Patient X, 29 y.

o, male admitted in surgical ward for total thyroidectomy under GETA

due to papillary thyroid carcinoma.

Instructions:

a. Illustrate the organ involved and label accordingly.

b. Discuss the normal function of the organ

involved.

• The thyroid gland is located in the

neck, just below the cricoids cartilage, and somewhat H- shaped.
• The thyroid is composed of two pear shaped lobes which extend from the
thyroid cartilage to the 6th tracheal ring on the anterior side of the neck.
• It lies over the trachea and is covered by layers of pretracheal fascia (allowing
it to move), muscle and skin.
• The two lobes are joined by the isthmus which overlies tracheal rings 2, 3 and
4.
• Each lobe is composed of irregularly shaped lobules, which consist of a
multitude of tiny sacs (follicles) filled with jelly-like, iodine-containing
substance called colloid.
• The main component of colloid is thyroglobulin- the storage form of the
hormone thyroxine. The parathyroid gland s are four glands near, attached to,
or embedded in the thyroid gland.
• Thyroxine or T4, triiodothyronine or T3 are actually two iodine-containing
hormones. Thyroid hormone controls the rate at which glucose is burned, and
converted to chemical energy to power their activities.

c. In your own understanding of the pt.’s. diagnosis, create a clinical pathway of the
factors contributing to your patient’s illness condition.

d. Explain the surgical procedure done on your patient. Why was the surgery done?

TOTAL THYROIDECTOMY

Thyroidectomy is a surgical procedure in which all or part of the thyroid gland is

removed. The thyroid gland is located in the forward (anterior) part of the neck just
under the skin and in front of the Adam's apple. The thyroid is one of the body's
endocrine glands, which means that it secretes its products inside the body, into the
blood or lymph. The thyroid produces several hormones that have two primary
functions: they increase the synthesis of proteins in most of the body's tissues, and
they raise the level of the body's oxygen consumption.

All or part of the thyroid gland may be removed to correct a variety of abnormalities.
If a person has a goiter, which is an enlargement of the thyroid gland that causes
swelling in the front of the neck, the swollen gland may cause difficulties with
swallowing or breathing. Hyperthyroidism (overactivity of the thyroid gland)
produces hypermetabolism, a condition in which the body uses abnormal amounts of
oxygen, nutrients, and other materials. A thyroidectomy may be performed if the
hypermetabolism cannot be adequately controlled by medication, or if the condition
occurs in a child or pregnant woman. Both cancerous and noncancerous tumors
(frequently called nodules) may develop in the thyroid gland. These growths must be
removed, in addition to some or the entire gland itself.

e. Enumerate the instruments that were used during the operation (use google to
search for instruments / procedure). Classify according to category, function

Instruments Category Function

f. List of Accessories used during the procedure

Accessories Category Function

g. Enumerate the sutures used in the procedure

Layer Type of Suture Color Needle

h. Formulate an immediate post – operative Nursing care plan according to the

identified nursing problems using the NANDA approves Nursing Diagnosis. Give at
least 3 . Prioritize the problems and cite your reference.