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).