Goiter

Definition

A goiter is a visible or palpable enlargement of the thyroid gland at the base of the neck. It may be diffuse or nodular and associated with euthyroid, hyperthyroid, or hypothyroid states.

Causes

• Iodine deficiency (most common worldwide)
• Graves' disease (hyperthyroidism)
• Hashimoto thyroiditis (hypothyroidism)
• Thyroid nodules, cysts
• Thyroid cancer
• Pregnancy

Signs and Symptoms

Visible neck swelling, dysphagia, dyspnea, hoarseness (if pressing on recurrent laryngeal nerve). Associated thyroid function symptoms (heat/cold intolerance, weight changes, tremor, lethargy).

Nursing Interventions

Assess thyroid function (TSH, free T4), iodine status, and compression symptoms. Provide thyroid-specific treatment: iodine supplementation, antithyroid drugs (methimazole, PTU), levothyroxine, radioactive iodine, or surgery. Post-thyroidectomy: monitor for hemorrhage, airway compromise, hypocalcemia (tetany; chvostek's and Trousseau's signs), laryngeal nerve injury.

NCLEX Relevance

Post-thyroidectomy priority: airway and hypocalcemia.