Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 8 Endocrine System^337



  • Administer beta blockers such as propranolol until hyperthyroidism dimin-
    ishes to decrease sympathetic activity and control tachycardia, tremors, and
    anxiety.


NURSING DIAGNOSES



  • Imbalanced nutrition: less than what body requires related to inadequate intake
    in relation to metabolic needs

  • Fatigue related to sleep deprivation

  • Hyperthermia related to increased metabolic rate


NURSING INTERVENTION



  • Monitor vital signs.

  • Provide cool environment.

  • Protect the patient’s eyes with dark glasses and artificial tears if the patient
    has exophthalmos.

  • Provide a diet high in carbohydrates, protein, calories, vitamins, and
    minerals.

  • Monitor for laryngeal edema following surgery (hoarseness or inability to
    clearly speak).

  • Keep oxygen, suction, and a tracheotomy set near bed in case the neck swells
    and breathing is impaired.

  • Keep calcium gluconate near the patient’s bed following surgery. This is the
    treatment for tetany and is used to maintain the serum calcium level in nor-
    mal range.

  • Place the patient in a semi-Fowler’s position to decrease tension on the neck
    following surgery.

  • Support the patient’s head and neck with pillows.

  • Monitor for muscle spasms and tremors (tetany) caused by manipulation of
    the parathyroid glands during surgery.

  • Check drainage and hemorrhage from incision line; red flags are frank hemor-
    rhage and purulent, foul smelling drainage.

  • Monitor for signs of hypocalcemia (tingling of hands and fingers).

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