Orem’s Theory in the Management of Post-thyroidectomy

Post throidectomy Nursing Care Plan Orem’s Theory in the Management of Post thyroidectomyDorothea E. Orem’s “Self-Care Deficit Theory of Nursing”. Orem’s model elicits the theory of self-care deficit and the role of the nursing system. Self-care is the practice of activities of daily living (ADL) that an individual personally initiates and performs on their own behalf to maintain health and well-being, as well as life as a whole. In case that the patient is unable to attain self-care (self-care deficit) because of any circumstances like sickness or disability, then, it is the responsibility of the nurse to provide care for the patient through nursing interventions. The theory is divided into three categories—universal self-care requisites, developmental self-care requisites and health-deviation self-care requisites (Tomey & Alligood, 2002; Laurente et al., 1997). Universal self-care requisites are self-care demands based on the individual’s ability to actively meet such need. Promotion of processes of life and maturation, prevention of condition deleterious to maturation or that mitigate deleterious effects are the focus of developmental self-care requisites. Health-deviation self-care requisites are the care needed by an individual with illness, disease or injury that requires additional demands of self-care (Laurente et al., 1997).

Thyroidectomy is the surgical removal or resection of the thyroid gland (Smeltzer & Bare, 2004). Thyroid surgery is usually indicated for most cases of thyroid problems such as severe thyroid infection, hyperthyroidism, hypothyroidism, thyroid malignancy and neoplasm. In the study of Ozbas and colleagues (2005) stated that surgical resection is the treatment of choice for multinodular goiter. Compression-induced symptoms, suspected malignancy, hyperthyroidism and cosmesis are the indications for thyroid surgical operation. Surgical options include bilateral subtotal thyroidectomy, near total thyroidectomy, partial thyroidectomy and total thyroidectomy. Sharma & Barr (2010) delineated the complications of thyroid surgery such as post-operative surgical site seranomas and poor scar formation (minor complications); sympathetic trunk damage (rare complication); bleeding and hematoma, laryngeal nerve injury, hypoparathyroidism, thyrotoxic storm, infection and hypothyroidism (major complications).

Surgical operation cannot be avoided if it is the only means of treatment. Moreover, thyroid surgery complications can be prevented if the patients are being handled by an experienced and well-trained surgeon. But the improvement of the post-thyroidectomy patients depends on the nurses who attend to them post-operatively. It is the function of the nurse to attend to their needs and prepare them for home discharge to avoid recurrent of condition for cases of partial thyroidectomy and prevent post-operative complications. Healthy living starts with knowledge.

References:

  • Doenges, M. E. et al. (1997). Nursing Care Plans: Guidelines for Individualizing Patient Care, 4th ed. Philadelphia: F.A. Davis Company, 452–454.
  • Jonhson, M. et al. (2007). NANDA, NOC, and NIC Linkages: Nursing Diagnoses, Outcomes, & Interventions, 2nd ed. Singapore: Mosby Elsevier, 257, 259, 303– 305. Laurente, C. M. et al. (1997). Advanced Adult Health Nursing. Philippines: UP Open University Publication, 273–278, 283–299, 345–395.
  • Myers, J. L. & Gulanick, M. (2007). Nursing Care Plans: Nursing Diagnosis and Intervention, 6th ed. Singapore: Mosby Elsevier, 1080–1082. Ozbas, S. et al. (2005). Comparison of the Complications of Subtotal, Near Total and Total Thyroidectomy in the Surgical Management of Multinodular Goitre. Endocrine Journal, 52 (2), 199–205.
  • Sharma, P. K. & Barr, L. J. (2010). Complications of Thyroid Surgery, Medscape Reference : Drugs, Diseases and Procedures, http://emedicine.medscape.com/article/852184. Smeltzer, S. C. & Bare, B. G. (2004). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 10th Ed. PA: Lippincott Williams & Wilkins, 1206. Tomey, A. M. & Alligood, M. R. (2002). Nursing Theorists and Their Work, 5th ed. Singapore: Mosby Elsevier, 189–201, 212–219.

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About Danela Cosejo

She is currently working as a medical-surgical nurse at Ministry of Health, Sultanate of Oman. A writer, blogger, researcher, correspondent and publication consultant for nursing journal and health-related educational websites. Her field of specialization focused on Intensive Care and Emergency Management. She is now taking up MAN major in Adult Health Nursing at the University of the Philippines Open University. A nursing professor for 8 years in the Philippines and served as a staff nurse at UST hospital. A caring and devoted nurse who introduced a “Pinay Nightingale” in the land of the pharaohs. A nurse by profession, an educator by devotion and a writer / researcher by passion.

3 thoughts on “Orem’s Theory in the Management of Post-thyroidectomy

    • Danela Cosejo-Oloresisimo RN Post author

      Ms. Latrina Engelberg: So sad to hear that … hope your friend will get well soon. Don’t worry, though hyperthyroidism exhibits cardiac symptoms, cardiac failure rarely occurs.
      Hyperthyroidsm causes overproduction of thyroid hormone. Thyroid hormone increases the force of contraction of the heart, and the amount of oxygen demanded by the heart muscle, thus increasing the heart rate; palpitations occur. Another reason is that, hyperthyroidism increases the nitric oxide in the blood vessels causing dilatation and stiffness, in these cases… heart function and pumping mechanism are greatly increased.