Thyroid is destroyed life long thyroid hormone

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thyroid is destroyed, life long thyroid hormone replacement Surgical: Total thyroidectomy or subtotal thyroidectomy o Treated with drug therapy to get the thyroid to normal function before surgery o Post-operative o Teach patient to support neck when moving, coughing o VS q 15 minutes o Sandbags to support head, semi-fowler’s position o Humidifying the air o Deep breathe, cough q 30 minutes o Monitor for tetany-resulting from hypocalcemia o Risk for hemorrhage, inspect dressing and drain o Risk for Respiratory distress, STRIDOR (harsh, high pitched respiratory sounds is heard in acute respiratory distress
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o Make sure oxygen and suctioning equipment is working and ready to use o Keep emergency tracheostomy equipment in the patient’s room o Prednisone in severe cases to reduce swelling o Diuretics to reduce swelling around the eyes o Teach patient to report tenderness, redness, drainage or swelling to physician once discharged, sutures removed 3-4 days post-op o Explain about mood swings Hypothyroidism is the result of levels of thyroid hormones o Due to damage to cells or failure to ingest iodide and tyrosine for production of thyroid hormones. o Result is low metabolic rate results in overproduction of thyroid stimulating hormone which enlarges the thyroid gland, forming goiter o Myxedema coma is a rare serious complication, decreased metabolism cause heart muscle to become flabby and chamber size enlarge, result is decreased cardiac output and decreased perfusion. o Mortality rate is extremely high and considered life-threatening emergency. o Etiology of Hypothyroidism is usually the result of thyroid surgery. Or can be lack of natural iodide causing endemic goiter. o Potential for myxedema coma with hypothyroidism Nursing interventions o Emergency Care of the patient During Myxedema coma o Maintain a patent airway
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o Replace fluids with IV normal or hypertonic saline as prescribed o Give levothyroxine sodium IV as prescribed; Give glucose IV as prescribed o Give Corticosteroids as prescribed; Check the patient’s temperature hourly o Monitor blood pressure hourly; Cover the patient with warm blankets o Monitor for changes in mental status; Turn every 2 hours, o Institute Aspiration Precautions
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