THYROID CANCER

Question 1

primary sign of thyroid cancer.

Answer 1

The presence of a painless, palpable nodule or nodules in an enlarged thyroid gland

Question 2

Parathormone Function:

Answer 2

Parathormone is responsible for controlling the calcium level in the body.
How? If the calcium level in the blood is low → parathormone will be released→it will tell the bone to release calcium in the blood → if the calcium is released the bone will be brittle and fragile.

Question 3

Since there is no longer thyroid gland, what drug will be taken by the patient lifetime?

Answer 3

Thyroxine

Question 4

BEST POSITION

Answer 4

Semi Fowler Position
the thyroid gland is highly vascular. There will be edema and bleeding and will cause pressure to the trachea → cause respiratory distress. → PLACE IN SEMI FOWLER
Rationale: Because of gravity it will lessen the edema it goes back to the right side of the heart →less edema → less pressure in the trachea.

Question 5

WHY DO WE NEED TO SUPPORT HEAD IN A NEUTRAL POSITION AND HOW?

Answer 5

Roll a towel or small pillow→ place it on both sides so the head will not be moved.
RATIONALE: If the pt undergone thyroidectomy→pt can turn their head → it can cause tension to the suture site → it will cause bleeding → always support the head in a neutral position.
If the pt wants to look on their side → what will you tell? → tell them if they want to look on their side move also their shoulder → head should move together with their shoulder.

Question 6

BLEEDING COMPLICATION

Answer 6

ELEVATE → look at the dressing → since pt is in recumbent position→ check also at the back of the dressing → since the blood can go there → don’t assess only the front →blood can be accumulating there.
If internal bleeding → check bp → if there is bleeding Bp will fall
Cold beverage → it causes vasoconstriction→so there will be less bleeding.
(cold water, cold juice, popsicles)
no pulp→it can cause irritation→ pt keep on coughing → cause bleeding.
If they can eat→ soft diet→ any food that can be easily digested.

Question 7

HOW TO CHECK FOR LARYNGEAL NERVE DAMAGE

Answer 7

Instruct patient not to talk too much → if they do → it will cause edema in the vocal chord (larynx)
how will you test that?
nurse assess it q2
ask question → answer should not be long → where do you live? → ahh in sta. Ana → is it clear or hoarseness of voice
hoarseness is normal until 3rd postoperative day →because there is edema → because of incision → after 3rd the voice should be clear.
There is laryngeal nerve damage if there is still hoarseness after the 4th or 5th post op day.

Question 8

HOW TO CHECK FOR TETANY?

Answer 8

Why is there tetany?
when there is thyroidectomy → the doctor may also cut the parathyroid gland→ it will cause less calcium level in the body
HOW TO KNOW IF THERE IS TETANY?
Tingling sensation around the mouth and fingers → low calcium
When you tap the facial nerve front of the ear there is facial spasm → (+) Chvostek sign
Put the BP cuff in the arm of the patient. If the systolic BP is 120 you can increase it to 20mm and leave it for 1-3 minutes inflated. → when patient shows the carpopedal sign → (+) trouser sign