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Nursing Care Plan for Thyroid Cancer - Assessment, Diagnosis and Interventions
DEFINITION OF THYROID CANCERThyroid cancer is a malignancy of the thyroid, which has 4 types, namely: papillary, follicular, anaplastic and medullary. Thyroid cancer rarely causes enlargement of the gland, more often causes a small growth (nodules) in the gland. Most thyroid nodules are benign, thyroid cancer is usually curable.
Thyroid cancer often limits the ability to absorb iodine, and limit the ability to produce thyroid hormone, but sometimes produce enough thyroid hormone, causing hyperthyroidism.
ETIOLOGY THYROID CANCER
The etiology of this disease is uncertain, which acts specifically to occur well differentiated (papillary and follicular) are the radiation and endemic goitre, and for medullary type is genetic factors. Not known a carcinoma, which for anaplastic and medullary cancer.
Radiation is one of the etiological factors of thyroid cancer. Many cases of cancer in children previously received radiation to the head and neck because of other diseases. Usually the effects of radiation occur after 5-25 years, but an average of 9-10 years. TSH stimulation of the old is also one of etiological factors of thyroid cancer. Other risk factors are family history of thyroid cancer and chronic goiter.
ASSESSMENT OF THYROID CANCER
- Client and family health history. When a client suffering from the disease and whether any family members who suffer from the same disease.
- Habits of daily living, such as :
- Diet Pattern
- Sleep patterns (clients spend a lot of time to sleep).
- Activity pattern
- Residence now and at the time a toddler.
- The main complaints of clients, including disruption in various body systems;
- Pulmonary system
- Digestive system
- Cardiovascular system
- Musculoskeletal system
- Neurologic Systems and Emotions / psychological
- Reproductive system
- Metabolic
- The physical examination includes :
- General appearance; observe clients face to the presence of edema around the neck, the presence of an enlarged nodule around the neck.
- Enlarged heart, dysrhythmias, and hypotension, decreased pulse, physical weakness.
- Paresthesias and decreased tendon reflexes.
- The voice was hoarse and sometimes can not be issued until the noise.
- When a large nodule can cause shortness of breath.
- Psychosocial Assessment of the client: it is very difficult to develop social relationships with the environment, self-isolation / even mania. Families complain client is very lazy bunch, and wanted to sleep all day. Assess how the client's self-concept includes all five components of self-concept.
- Other assessments concerning the occurrence of hypothyroidism.
NURSING DIAGNOSIS AND NURSING INTERVENTIONS FOR THYROID CANCER
1. Acute Pain
Related to:
pressure / swelling of the tumor nodule
Possible evidenced by:
- The existence of the neck pain may spread to the orbital area.
- Pain scale of 0-10
- Looks withstand pain
- There is pain in swallowing, and difficulty swallowing
Expected results:
- Pain reported lost / reduced
- Pain scale of 0-2
- Looks relaxed
- No complaints when swallowing
- Observe for signs of pain both verbal and nonverbal
- Teach and encourage patients to use relaxation techniques
- Collaboration of analgesic
2. Ineffective airway clearance
Related to:
- Tracheal obstruction due to tumor mass pressure
- Laryngeal spasm
- Accumulation of secretions
Possible evidenced by:
- Difficulty breathing
- Difficulty of removing secret
- Complained of shortness of breath
- Above normal respiration
Expected results:
- There is no difficulty breathing
- Secret easy exit
- Do not complain shortness of breath
- Respiration in the normal range (16-20)
- Monitor respiratory frequency, depth of breathing
- Auscultation of breath sounds, record a Ronchi
- Assess the dyspneu, stridor and cianosis
- Note the quality of the respiratory
- Practice deep breathing or coughing and effective as indicated
- Investigate the secret accumulation and exploitation done with caution as indicated
- Collaboration of Ogsigen therapy if necessary
3. Impaired Verbal Communication
Related to:
- Injury to vocal cords
- Laryngeal nerve damage
- Tissue edema
Possible evidenced by:
- Talk husky / can not speak
Expected results:
- Being able to create a method of communication in which needs can be understood
- Periodically examine the function of speech
- Keep communication simple
- Provide a suitable alternative method of communication
- Anticipation of needs as possible
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