Info

Drug Class

Dosage

Description

Rationale

Levothyroxine

2.6 |g/kg per day for

Synthetic T4

Suppresses TSH levels and establishes

(Synthroid)

7-10 days

hormone

a euthyroid state postoperatively

Independent

The most important nursing interventions focus on teaching and prevention of complications. When you prepare patients before surgery, discuss not only the procedure and aftercare but also the methods for postoperative communication such as a magic slate or a point board. Explain that the patient will be able to speak only rarely, will need to rest the voice for several days, and should expect to be hoarse. Answer all questions before surgery. After the procedure, monitor the patient's ability to speak with each measurement of vital signs. Assess the patient's voice tone and quality, and compare it with the preoperative voice.

Maintain the bed in a high-Fowler position to decrease edema and swelling of the neck. To avoid pressure on the suture line, encourage the patient to avoid neck flexion and extension. Support the head and neck with pillows or sandbags; if the patient needs to be transferred from stretcher to bed, support the head and neck in good body alignment.

Before discharge, make sure that the patient has a follow-up appointment for a postdischarge assessment. Make sure that the patient has the financial resources to obtain all needed medications; some patients require thyroid supplements for the rest of their lives. Refer the patient or family to the American Cancer Society for additional information.

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