TEST QUESTION: Post Op Partial Thyroidectomy


CORRECT ANSWER A) BP 86/50

Monitoring the patients blood pressure is extremely important after surgery because a drop could mean hemorrhage. It’s also important to assess the drainage from the dressing. Usually hemorrhage risk is greatest in the first 24 hrs


OTHER ANSWERS EXPLAINED

Laryngeal nerve damage is important to assess post op. A patient may have permanent hoarseness and/or not able to talk quite as loud. Often however, hoarseness is common normal finding immediately after surgery. This hoarseness is related to the use of the endotracheal tube & also likely edema post-op. Usually this resolves. Most patient’s hoarseness resolves within 6 weeks, however can take up to 6 months. Unresolved hoarseness and other changes in the voice are a concern for laryngeal nerve damage.

The normal calcium range is 8.5-10.2 (epocrates). Although 8.2 is lower than the normal it wouldn’t be priority over the blood pressure answer. And an ionized calcium should be checked as well. Hypocalcemia after thyroidectomy is a possibility and may need to be replaced. It’s important to check for twitches, chvostek & trousseau sign, confusion, psychosis. Seizures can also happen. During a thyroidectomy there is potential that the parathyroid glands are damaged and or removed. This may lead to hypocalcemia.

Sitting semi-fowlers helps to decrease the strain on suture line. It’s also a good idea to support the back of the neck with pillows.


REFERENCE

  1. Subtotal Thyroidectomy http://wps.prehall.com  -check out this site’s great care plans!!
  2. Photo credit- by Samuel Zeller on unsplash.
DISCLAIMER: The information posted is not intended to be medical advice. Check with your primary care provider regarding questions about your health. This post and all other posts are for educational purposes only. This information is intended for medical professionals & students. This is not intended to guide in medical decisions or treatment in any way. As always, medical professionals should call the on call provider if any clarifications are needed. State and hospital protocols should always be followed accordingly. Med Made Ez (MME) disclaims any liability for the decisions you make based on this information.

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