Teach the patient to avoid medications and foods that lead to endemic or sporadic goiter. Patients with endemic goiter should use iodized salt to supply at least 300 µg of iodine daily to prevent goiter. Be sure the patient understands all medications, including the dosage, route, action, adverse effects, and the need for any laboratory monitoring of thyroid medications. Encourage the patient to take thyroid hormone supplements at the same time each day to maintain constant thyroid levels in the blood.

Have the patient immediately report to the physician any signs and symptoms of thyrotoxic crisis; these include rapid heart rate and palpitations, perspiration, shakiness and tremors, difficulty breathing, and nausea and vomiting. Teach the patient to report any increased neck swelling, difficulty in swallowing, or weight loss.

If the patient had surgery, teach him or her to change any dressings; to inspect the incision for redness, swelling, and discharge; and to notify the physician about changes that indicate infection.