Thyroidectomy Nursing Care Plan Notes

Removal of all or a portion of the thyroid gland.
The procedure is usually performed to treat various disease of the thyroid gland that may not be treated effectively by chemotherapy or medication.
A total thyroidectomy is indicated for certain carcinomas and to relieve tracheal or esophageal compression.

Supine with rolled towel or sandbag between the scapulae, hyperextending the neck. If table is placed in reverse Trendelenberg position, a padded foot board should be used to prevent the patient from slipping down toward the end of the table.

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The incision is made above the sternal notch.
The platysma muscle is incised and retracted.
The strap muscles are separated or divided, and blunt and sharp dissections are employed until the thyroid is exposed.
The gland is then mobilized, and all or part is removed depending on the involved pathology.
Hemostasis is obtained, and the wound is irrigated with warm saline.
A drain may be inserted, and the incision is closed in layers by an interrupted method.

The surgeon may request a fine silk suture to use to mark the incision line.
The dressing is usually secured by a thyroid collar using a towel folded in thirds lengthwise. The towel is placed around the neck and crisscrossed in front, then fastened with tape.
The scrub person should maintain the sterility of the back table/ Mayo until the patient is extubated and breathing is stabilized.
An emergency tracheostomy tray will accompany the patient to the postanesthesia care unit and later to the patient’s room until breathing is unlabored and the chance of airway obstruction secondary to edema has passed.