Medications- Patient is for discharge, with the following take home medicine such as: Cefuroxime 500 mg I tab

every 8 hours for 5 days Mefenamic acid 500mg every 6 hours Calcium carbonate 500mg I tab twice a day Instruct the patient to religiously take the ordered medications at the right time, dosage, and frequency. Exercise - Total thyroidectomy actually requires time to recover. It is advised to have 4 to 6 weeks duration time for recovery. Once home, it is possible to tire more easily than usual to begin with, so it is important to take it easy. Avoid straining at the affected area. Strenuous exercise and lifting should be also avoided. Light exercise such as walking, deep breathing and coughing exercise are recommended. Normal activities, including returning to work, can usually be resumed after about a week. Treatment - Multinodular Non-toxic Goiter disease usually is treated by removing the thyroid gland. Now that the patient had her thyroid gland removed, the rest is up to her. It is important to rest and let the body recover after surgery. Consequently, to prevent other complications, she must have her lifestyle and diet modified. Health Teaching - Explain to patient what to expect afterwards. As the anesthetic wears off, there is likely to be some pain. The anesthetist will prescribe painkillers. Suffering from pain can slow down recovery, so it's important to discuss any pain with the doctors or nurses. On discharge, patient must advise about caring for the stitches, hygiene and bathing, and will arrange an outpatient appointment for the stitches to be removed, if necessary. Some people will have dissolvable stitches, which do not need to be removed. Instruct patient to comply with the take home medications that would be given by her physician. Remind her to complete the full course of the antibiotic treatment. Encourage patient to do the recommended light exercises such as walking. Avoid doing strenuous activities which could slow down his recovery. Encourage him to comply with the dietary modifications; moderate the intake of iodine rich food to prevent the occurrence of serious post-total thyroidectomy side-effects. Explain to patient to refer for unusual signs and symptoms of any untoward feelings immediately regarding to her condition. OPD Follow-up Remind patients that regular check-ups are important to ensure that the patient condition is constantly monitored by the doctor. If any of the following symptoms are noted, he should contact her doctor: the wounds start to bleed wound become more painful, red, inflamed or swollen the abdomen swells pain is not relieved by the prescribed painkillers a fever develops. These could be signs of an infection that may need to be treated with antibiotics Diet- In time, patients who have suffered total thyroidectomy are exposed to a high risk of developing osteoporosis, and other bone diseases due to lack of calcium in the bone as well as in the blood. In order to prevent the occurrence of serious post- total thyroidectomy complications, operated patients need to make drastic lifestyle and dietary changes. The patient

was ordered to take high protein foods for faster tissue repair and instructed on Diet as tolerated. People who had thyroid removal surgery are advised to eat smaller meals. Considering the fact that the metabolism is affected due to absence of thyroid gland and its hormone that helps our body to regulate metabolism. Operated patients also need to take vitamin and mineral supplements and artificial hormone for the replacement of the hormones came from thyroid gland that aids the metabolism. Spiritual- Provides emotional support coming from family. Encouraged the patient to participate in the community services to promote social supportive relationship.