Nursing care of a total thyroidectomy patient with postoperative critical hypocalcemia with acute respiratory failure: a case study

Abstract

     This study was case study aimed to study nursing care for total thyroidectomy patient with postoperative critical hypocalcemia and acute respiratory failure. Case study of a Thai female patient, age 59 years old, admitted to Banmi Hospital on 22 February 2023 with symptoms of a large lump on her neck before coming to the hospital for 1 month. The doctor made an appointment for the patient to come to the hospital for thyroid surgery.

     Results: Patients have problems before surgery, including anxiety due to lack of knowledge about the disease, treatment, and how to behave before and after surgery. During the postoperative period, the patient had low calcium in the blood and anemia from blood loss during surgery of 800 ml. Day 2 after surgery, the patient had a critical condition after the removing tracheal tube. This is due to the patient's upper respiratory tract being obstructed. As a result, the patient has acute respiratory failure. Therefore, the patient received a tracheal tube again and used a ventilator. The patient received a tracheotomy. When the critical period passed, the patient was taken off the ventilator but the tracheostomy tube had not yet been removed. Because the results of endoscopy examining the larynx and trachea found that the patient had vocal cord paralysis. Nurse and health team participated in planning patient discharge.Doctors provide knowledge about disease, disease pathology, prognosis, and teaching home care management for caregivers, emphasizing tracheostomy tube care to prevent upper airway obstruction and monitoring for complications from thyroid surgery, including hypocalcemia.. The patient was hospitalized for a total of 17 days.