Nicole C.

Campillo April 12, 2023

BSN3-13E

THYROID LOBECTOMY
Total thyroidectomy involves the removal of the entire thyroid gland. This procedure is most often performed to treat thyroid cancer, but
it may also be performed to treat uncontrollable hyperthyroidism or goiter that causes severe symptoms. If you're having thyroidectomy as a
result of thyroid cancer, we may remove lymph nodes around your thyroid to be examined by a pathologist. We use the smallest incisions
possible, to limit scarring to your neck and deliver the best possible cosmetic results. General anesthesia is used during a thyroidectomy, and
you'll usually stay in the hospital for one night following the procedure. A thyroid lobectomy is used to remove one of your two thyroid lobes,
leaving the other intact. We may perform this type of surgery if there are nodules that cause symptoms or could be cancerous. We also use it to
treat excessive hormone production like that associated with hyperthyroidism.
If you are having a thyroid lobectomy because of an indeterminate biopsy result, we will send the tissues collected to a pathologist for
examination. If cancer is found, you might have to undergo a second surgery to ensure that all of the cancerous tissue is removed. A thyroid
lobectomy is performed under general anesthesia and is often an outpatient procedure. However, if you require a hospital stay, our nursing staff
are experts in managing your post-operative care and transitioning you to continued recovery at home. After a thyroid lobectomy, you'll need to
have your thyroid levels checked. Depending on the results, you may need thyroid hormone replacement.
POSITION OF PATIENT DURING SURGERY
 NURSING RESPONSIBILITIES
SCRUB NURSE
Before an operation
 Ensures that the circulating nurse has checked the equipment
 Ensures that the theater has been cleaned before the trolley is
set
 Prepares the instruments and equipment needed in the
operation
 Uses sterile technique for scrubbing, gowning and gloving
 Receives sterile equipment via circulating nurse using sterile
technique
 Performs initial sponges, instruments and needle count, checks
with circulating nurse
During an operation
 Maintain sterility throughout the procedure
 Awareness of the patient’s safety
 Adhere to the policy regarding sponge/ instruments count/
surgical needles
 Arrange the instrument on the mayo table and on the back table
End of Operation
 Undertake count of sponges and instruments with circulating
nurse
 Informs the surgeon of count result
 Clears away instrument and equipment
 After operation: helps to apply dressing
 Removes and disposes of drapes
 De-gown
 Prepares the patient for recovery room
 Completes documentation
 Hand patient over to recover room
CIRCULATING NURSE
Before an operation
 Checks all equipment for proper functioning such as
cautery machine, suction machine, OR light and OR
table
 Make sure theater is clean
 Arrange furniture according to use
 Place a clean sheet, arm board (arm strap) and a
pillow on the OR table
 Provide a clean kick bucket and pail
 Collect necessary stock and equipment
 Turn on aircon unit
 Help scrub nurse with setting up the theater
 Assist with counts and records.
During Operation
 Remain in theater throughout operation
 Focus the OR light every now and then
 Connect diatherapy, suction, etc.
 Position kick buckets on the operating side
 Replenishes and records sponge/ sutures
 Ensure the theater door remain closed and patient’
s dignity is upheld
 Watch out for any break in aseptic technique
End of Operation
 Assist with final sponge and instruments count
 Signs the theater register
 Ensures specimen are properly labeled and signed
 10 SURGICAL INSTRUMENTS USED DURING THYROID LOBECTOMY

1. Allis Forcep – It is used is grasping organ or tissue that is being removed.

2. Kelly Forcep – It is usually used in clamping tissue or vessels.
3. Debakey Forcep – It is for grasping fine tissue; commonly used in all types of surgery.
4. Adson Tissue Forcep – Is for grasping skin layer during wound closure.
5. Right Angle Clamp – Is used for clamping bowel.
7. Knife Handle – For holding knife blades
8. Straight Mayo Scissor – It is for cutting sutures, dressings, and drains
9. Richardson Retractor – Is used to expose wounds.
10. Yankauer Suction – For suctioning fluid or blood; and may be used to suction smoke
 NURSING CARE PLAN

CUES NURSING DIAGNOSIS GOAL & OBJECTIVES INTERVENTIONS RATIONALE EVALUATION

Subjective: Risk for Infection Within 8 hours of 1. Assess temperature 1. Provides information After 8 hours of
Related to Surgical nursing intervention, respiratory and urinary system about the presence of nursing
“Ma’am medyo Incision Secondary to changes as the disease infection caused by interventions, the
sakit nga katol the patient will remain progresses progressive chronic
Subtotal patient was able
akong gioperahan free of infection disease and its
Thyroidectomy to remain free of
po naunsa mani deteriorating effect on all
infections as
sya, as verbalized systems.
by the patient.” 2. To determine the evidence by vital
2. Assess lab results for
infection (elevated WBC and current health status of signs within the
Objective: positive, neutrophils and the patient normal range and
 Postoperati bilirubin). absence of signs
ve Patient SCIENTIFIC BASIS and symptoms of
 Surgical infection.
Incision 3. Assess for the presence of 3. Signs and symptoms
Risk for infection is a local infectious processes in the include localized
 Increased
vulnerable to invasion skin or mucous membranes. swelling, localized
levels of
and multiplication of redness, pain or
thyroid
pathogenic organisms, tenderness, loss of
hormone
which may compromise function in the affected
 Restless
health. area, palpable heat.
Hyperbilirubinemia can 4. Proper nutrition place
Lab 4. Provide diet restriction as
increase the risk of a part in supporting the
s: indicated, while providing
infection because immune systems’
adequate calories
WBC:11,700 bilirubin, a waste responsiveness
K/uL (↑) product of red blood 5. Aseptic technique
5. Maintain strict asepsis, for
cells, has been shown decreases the chances
neutrophi dressing changes, wound care,
to have of transmitting or
ls: intravenous therapy, and
immunosuppressive spreading pathogens to
catheter handling.
 76% effects. or between patients.
(↑) Interrupting the chain
T. Bilirubin: infection is an effective
3.1 Reference: way to prevent the
spread of infection.
(↑)
Doenges, M.E.,
D. Bilirubin: Moorhouse, M.F., &
 2.2 (↑)
Murr, A. C. (2022).
Nurse’s pocket guide:
Diagnoses, prioritized
interventions, and
rationales. F.A. Davis
Company.