Thyroidectomy

A thyroidectomy removes all of the thyroid gland (total thyroidectomy) or one lobe (hemithyroidectomy). It may be performed for thyroid cancer, a compressive goitre, suspicious nodules, or hyperthyroidism that is not adequately controlled with other therapy. The operation takes place in a small, crowded area of the neck. The trachea, recurrent laryngeal nerves, and parathyroid glands lie immediately beside or behind the thyroid. This anatomy explains the complications that demand the nurse’s attention after surgery: - Bleeding in the closed neck space can form a hematoma that compresses the trachea. - Recurrent laryngeal nerve irritation or injury can alter the voice, weaken the cough, or, if both vocal cords are affected, obstruct the airway. - Parathyroid gland trauma, removal, or reduced blood supply can decrease parathyroid hormone secretion and cause hypocalcemia. The parathyroid glands act as the body’s calcium regulator. When parathyroid hormone falls, calcium is not maintained effectively in the bloodstream. The patient may initially have a normal calcium level, then develop tingling, muscle irritability, tetany, or dysrhythmias as calcium declines. An early postoperative iPTH level gives an early...