[Exam 4] Chapter 52 - Thyroid Cancer

Question 1

Thyroid Cancer: Is this treatable?

Answer 1

Yes, this is fairly treatable

Question 2

Thyroid Cancer: What are the different Types?

Answer 2

Papillary Adenocarcinoma

Follicular Adenocarcinoma

Medullary

Anaplastic

Thyroid Lymphoma

Question 3

Thyroid Cancer: Which type is the most common?

Answer 3

Papillary Adenocarcinoma

Question 4

Thyroid Cancer: What are some causes of this?

Answer 4

Radiation Exposure (Linked to frequent dental X-Rays where patients are younger)

Question 5

Thyroid Cancer: Most common in who?

Answer 5

3/4 of cases occur with females

Question 6

Thyroid Cancer: This is often found how?

Answer 6

The patient has a enlarged thyroid, may palpate the lump or nodule

Question 7

Thyroid Cancer: This is diagnosed how?

Answer 7

With an ultrasound

Question 8

Thyroid Cancer: If the lump is suspicious after ultrasound, what is then done?

Answer 8

Biopsy may be done and may do some lymph node mapping since there may be a lot of lymph node involvement.

Question 9

Thyroid Cancer: What parts of the body may receive a biopsy?

Answer 9

The thyroid, the lymph nodes to determine if this is cancerous or not.

Question 10

Thyroid Cancer - Medical Mx: What surgery may be done?

Answer 10

Thyroidectomy, so removal of the thyroid occurs. Tx of choice. Can also be a partial thyroidectomy.

Question 11

Thyroid Cancer - Medical Mx: What is the other treatment of chocie for this?

Answer 11

Radioactive Iodine.

Question 12

Thyroid Cancer - Medical Mx: Why is radioactive iodine sometimes still performed?

Answer 12

Because if the thyroid is removed, they may still have radioactive iodine to remove whatever is reamining.

Question 13

Thyroid Cancer - Medical Mx: How does radioactive iodine performed?

Answer 13

The patient is given a capsule that they can swallow

Question 14

Thyroid Cancer - Medical Mx: If a patient is to do have the radioactive iodine procedure, what is done beforehand?

Answer 14

Requires patient to go on low iodine diet two weeks prior. This is so body is deprived of iodine and when capsule is swallowed, the body soaks it up and goes to any remaining thyroid tissue and kill it.

Question 15

Thyroid Cancer - Medical Mx: What precautions will be taken with radioactive iodine procedure?

Answer 15

This is radioactive

Patients will need to stay away from children, maintain 6 foot distance.

Question 16

Thyroid Cancer - Medical Mx: What determines how long patient will need to stay away from others when they are taking radioactive iodine?

Answer 16

Depending on the dosage that was taken

Question 17

Thyroid Cancer - Medical Mx: What are some components of safety measures that come along with radioactive iodine?

Answer 17

Flushing the toilet when they go to bathroom, flush twice

Wash sheets daily so they are not reasborbing radioactive iodine.

Question 18

Thyroid Cancer - Medical Mx: So what is the biggest treatment that can be done for this?

Answer 18

Thyroidectomy and then radioactive iodine

Question 19

Thyroid Cancer - Nursing Mx: Preop will include what?

Answer 19

Educate patients on what to expect. Getting all/some thyroid removed

Will need to be on lifelong thyroid replacement, like Levothyroxine

Question 20

Thyroid Cancer - Nursing Mx: What will need to be done postoperatively?

Answer 20

Educating patient

Monitor airway, since surgery was on neck

Question 21

Thyroid Cancer - Nursing Mx: What may need to be done if patient developed stridor?

Answer 21

They may need to be intubated right away, or may need to use a trach kit that is kept bedside in case airway closes off.

Question 22

Thyroid Cancer -Nursing Mx: What potential complications may occur?

Answer 22

Hematoma underneath incision

Bleeding , JP drain inserted too help

Injury to laryngeal nerve (helps with breathing)

Hypocalcemia

Question 23

Thyroid Cancer -Nursing Mx: Why is a hematoma under incision site dangerous?

Answer 23

It is pressing on trachea and is going to affect the patient’s airway.

Question 24

Thyroid Cancer -Nursing Mx: If laryngeal nerve gets knicked, what problems may occur?

Answer 24

Complications or may lose voice after surgery. May come back over time or not. Can also cause problems with breathing.

Question 25

Thyroid Cancer -Nursing Mx: What is the biggest complication that can occur?

Answer 25

Hypocalcemia

Question 26

Thyroid Cancer -Nursing Mx: Why does hypocalcemia occur?

Answer 26

On back of thyroid, there is the parathyroid (4 little glands on pack) and embedded onto muscle on side of neck

These then take a hit and cannot absorb calcium

Question 27

Thyroid Cancer -Nursing Mx: What will be done for patient with hypocalcemia?

Answer 27

May be on calcium supplements afterwards to help restore calcium balance. Make sure to monitor calcium levels to make sure they don’t go too low or high. Usually low.

Question 28

Thyroid Cancer -Nursing Mx: What is an example of a calcium supplement to treat hypocalcemia?

Answer 28

TUMS, just like the kidney patients take for calcium. Its calcium carbonate

Question 29

Thyroid Cancer -Nursing Mx: How do you promote home and community based care?

Answer 29

Lifelong thyroid hormone replacement. Education on this

Will need follow up with endocrinologist for rest of life to monitor thyroid function, any return of thyroid cancer and adjust levothyroxine levels appropriately.