Features
Features:

Product Tour >

Edraw AI >

Paid Plans:

Individuals >

Business >

Eduaction >
Resources
Blog

History

How-tos & Tips

Discovery

Biography

Business Analysis

Examples

AI concept Map

Free AI Mind Map Generator

Onenote Mind Map

Bcg Matrix Examples

Nike Marketing Strategy

Unilever SWOT Analysis

Make Mind Maps in Google Docs

Guide

FAQs

What's New

Resource Center
Templates
All Templates

Brain Storming Templates

Strategy and Planning Templates

Project Management Templates

Product Management Templates

Human Resources Templates

Agile Workflow Templates

Marketing Templates

Education Templates

Fun and Games Templates

User Gallery
Download
Pricing
Enterprise

MindMap Gallery Care of patients with neck disease

Care of patients with neck disease

This is a mind map about the care of patients with neck diseases, including thyroid, thyroid disease, etc. The content is practical, friends who are interested can save it ~

Edited at 2024-04-08 09:05:24

PlotWizard

Recent works View more works>>

Care of patients with neck disease

PlotWizard

Recent works View more works>>

Recommended to you
Outline

chest disease
- 44
PlotWizard
increased intracranial pressure
- 49
PlotWizard
breast disease
- 61
PlotWizard
Anesthesia patient care
- 28
PlotWizard
surgical infection care
- 53
PlotWizard
Nursing care of patients with small bowel disease
- 48
PlotWizard

Care of patients with neck disease

thyroid

The superior level is the flat thyroid cartilage and the inferior level is located in the 5-6 tracheal rings.

The main blood supply to the thyroid gland comes from the superior and inferior thyroid arteries on both sides

Nerves only (both are vagus nerve)

recurrent laryngeal nerve

Unilateral damage

Hoarseness, aphonia

Bilateral damage

Difficulty breathing, suffocation

superior laryngeal nerve

Internal branch damage

Coughing after drinking water (sensory branch)

Damage to external branches

Lowered pitch (motor branch)

Thyroid disease

Hyperthyroidism

Classification

primary hyperthyroidism

Most common

The characteristic manifestation is: exophthalmos, so it is also called exophthalmic goiter.

secondary hyperthyroidism

secondary to nodular goiter

high functioning adenoma

Rare

pathology

Primary hyperthyroidism is an autoimmune disease

clinical manifestations

symptom

goiter

Diffuse, symmetrical swelling, generally no local compression symptoms

Symptoms of exophthalmos

There is no obvious relationship between the degree of exophthalmos and the severity of hyperthyroidism

systemic symptoms

That is, the symptoms of increased basal metabolic rate - emotional excitement, excessive appetite but weight loss, trembling hands, palpitations or arrhythmia, etc.

hormone imbalance

Irregular menstruation, impotence

physical signs

The pulse rate reaches more than 100 beats per minute and is still fast when resting and sleeping.

Increased pulse pressure

Palpable tremor and vascular murmur

Auxiliary inspection

basal metabolic rate

It must be done early in the morning on an empty stomach and while lying still

Basal metabolic rate % = (pulse rate + pulse pressure) – 111

Normal to ±10%

+20%-30% is mild hyperthyroidism

+30%-60% is moderate hyperthyroidism

+60% or above is severe hyperthyroidism

Thyroid 131I rate measurement

The speed of thyroid absorption and uptake of 131I

Normal - the amount taken within 24 hours is 30%-40% of the total amount

Hyperthyroidism

More than 25% of intake in 2 hours

More than 50% of the intake in 24 hours and the absorption peak appears earlier

Serum T3 T4 content measurement

T3 rises early and quickly, 4 times the normal value, and is more sensitive

treat

Drug treatment is the first choice

propylthiouracil

Methimazole (Tapazole)

131I treatment irradiates the thyroid gland to shrink its atrophy and necrosis

Surgical treatment

subtotal thyroidectomy

Nursing measures

Medication care

Use iodine immediately. Preoperative preparation time is less than 2 weeks.

Purpose: Reduce basal metabolic rate to below +20%

Iodine inhibits proteolytic enzymes and reduces the breakdown of thyroglobulin

Reduce thyroid hormone release

Thioureas must be used first and then iodine must be used

Thiourea drugs make thyroid congestion prone to bleeding during surgery, while iodine can shrink and harden it. Therefore, iodine must be added when using thiourea.

If the effect of taking iodine is not obvious first, then take thiourea drugs and then iodine.

When the above two drugs cannot be taken or are ineffective, use propranolol alone or in combination with iodine (no atropine anesthesia before surgery to avoid causing tachycardia)

Protruding eye care

Instill eye drops and antibiotic eye ointment to prevent dryness and infection, and to prevent conjunctivitis and keratitis

When conjunctival congestion and edema occurs, use 0.5% cortisone acetate eye drops and cold compress

Patients with severe impairment of eyelid closure should undergo eyelid suturing.

Nutritional support

Avoid eating centrally stimulating foods such as strong tea, coffee, smoking cessation and alcohol

High calories, high protein, high vitamins. Drink more water to supplement sweating and breathing to speed up water loss.

Postoperative care

general care

Position: Postoperative supine position, semi-sitting and recumbent position after blood pressure is stable, which is conducive to breathing and drainage.

Instruct the patient to maintain a comfortable head and neck position, and change the position to properly fix the neck to reduce vibration.

Drink warm and cool water and eat lukewarm liquids - avoid eating overly hot foods, which may cause blood vessels to dilate at the surgical site and aggravate bleeding.

prevent infection

Rational use of antibiotics

pain care

Recumbent position reduces wound tension

Give analgesics as directed by your doctor when necessary

Condition observation

vital signs

Incision care

Pay attention to the skin color of the neck and chest for patients undergoing laparoscopic areolar approach surgery

Because carbon dioxide gas will be injected during the operation, it may damage the subcutaneous fat layer and cause redness, swelling and ecchymosis, which usually gradually dissipates after 2-3 days.

Drainage tube care

Leave it for 24-48 hours. Fix it properly to prevent twisting, folding and pressure. Observe and record the color, nature and amount of the drainage fluid.

respiratory care

Encourage and assist patients to cough effectively and use aerosol inhalation to assist in the discharge of sputum when necessary.

drug care

Continue to take potassium iodide solution three times a day after surgery. Those who have taken propranolol before surgery continue to take it for 4-7 days.

Complication care

difficulty breathing and suffocation

The most critical postoperative complication

Mostly occurs within 48 hours after surgery

Recurrent laryngeal nerve injury

superior laryngeal nerve injury

hypoparathyroidism

thyroid storm

Thyroid tumor

Divided into follicular adenoma and papillary cystic adenoma

Follicular adenoma is common

Thyroid cancer

The most common is thyroid malignancy

clinical manifestations

symptom

lump

hard and fixed

systemic symptoms

Diarrhea Flushing Hypocalcemia

Horner syndrome (compression of cervical sympathetic ganglion)

Drooping eyelids on the affected side, no sweating on half of the face, constricted pupils, flushed complexion

Recurrent laryngeal nerve compression, hoarseness, tracheal compression symptoms, etc.

physical signs

The surface of the mass is uneven and the up and down movements are reduced when swallowing.

treat

non-surgical

Take thyroxine tablets for life

Postoperative 131I treatment

Traditional Chinese Medicine Treatment

Operation

It is the basic treatment method