A 17-Year-Old Girl with Cancer of the Thyroid Secondary to Leukemia

A 17-year-old girl with cancer of the thyroid secondary to leukemia went into remission 7 years earlier.She is in good health and eager to get back to school in time for the prom and final exams; however,she is very concerned about scarring from the surgery.The circulating nurse sat with the patient and encouraged her to discuss her fears and expectations.Together,they collaborated on a plan for the patient's discharge and care of her incision.The nurse documented the patient's nursing diagnosis as disturbed body image related to surgical scar in a prominent location.The nurse discussed the patient's concerns with the surgical team before the incision was made.The patient had a minimally invasive thyroidectomy approach,which left a small scar that was closed with a 4-0 nonabsorbable subcuticular suture.In the postoperative phase,the nurse provided the patient with her postoperative education relative to her incision.Select all the incision care instructions that would be relevant for the patient.

A) Instruct the patient to focus on positive feelings related to body image.
B) Instruct the patient in postoperative turning measures that decrease strain on the suture line.
C) Suggest accessories (e.g., jewelry, scarves, and certain necklines) that can be used to cover the scar until normal fading occurs.
D) Instruct her to refrain from prolonged exposure to direct sunlight or tanning salons while the incision is healing.
E) Use cosmetic creams with cocoa butter to decrease scarring and discoloration.