C.P. is started on oral calcium gluconate. Her calcium levels stabilize within 24 hours and she recovers

Question

without further complications. Two days postoperatively, you are preparing her for discharge.

As part of your discharge instructions, what would you teach C.P.? Select all that apply.
a. Keep her head raised while sleeping for 3 -4 days
b. The importance of keeping follow-up medical appointments
c. Not to return to work until her thyroid hormone level is normal
d. Cover her incision with clothing or sunscreen when she is in the sun
e. Proper care of the incision and signs of infection to report to the physician
f. To avoid foods containing iodine because they increase her risk of recurrent cancer

Answer 1

a, b, d, e
Patient education after subtotal thyroidectomy includes stressing the importance of follow-up
medical supervision. An essential part of this care is that thyroid hormone balance should be
monitored periodically to see whether normal function has returned. Most patients experience a
period of hypothyroidism after surgery because of the reduction in the size of the thyroid. However,
the remaining tissue usually hypertrophies and the patient is able to produce the hormone needed
by the body. Sleeping with the head of the bed elevated or sleeping in a recliner for 3 to 4 days will
help to decrease swelling. Covering the incision with clothing or very strong sunscreen when the
patient is in the sun will make the scar less visible. Teach the patient proper care of the incision site
and symptoms that might indicate development of an infection, in which case she should notify the
physician immediately. Although C.P. might feel tired for a while, there is no reason for her not to
return to work. Adequate iodine is necessary to promote thyroid function. Seafood once or twice a
week or normal use of iodized salt should provide sufficient intake.