A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?

Hypercalcemia and hyperkalemia

Muscle twitching and tingling around the mouth

Harsh, vibratory breath sounds

Hyperthermia and hypertension

Answer and Explanation

The Correct Answer is B

A. Hypercalcemia and hyperkalemia: These are not typical indicators of parathyroid damage. Hypercalcemia usually results from overactive parathyroid glands, while hyperkalemia is not a common result of parathyroid damage.
B. Muscle twitching and tingling around the mouth: These symptoms are indicative of hypoparathyroidism, a condition that can occur if the parathyroid glands are damaged during thyroid surgery. This results in hypocalcemia (low calcium levels), which causes neuromuscular symptoms like muscle twitching and tingling.
C. Harsh, vibratory breath sounds: These are not related to parathyroid damage. They may suggest respiratory issues, not problems with calcium regulation.
D. Hyperthermia and hypertension: These are not associated with parathyroid damage. They may be related to other post-surgical complications but not specifically to parathyroid gland injury.

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Correct Answer is D

Explanation

A. Ataxic dysarthria: This is not a common complication associated with Cushing syndrome. It is more related to neurological disorders affecting speech and coordination.
B. Hypotension: Cushing syndrome typically causes hypertension rather than hypotension due to fluid retention and increased vascular resistance.
C. Hyperkalemia: Cushing syndrome is associated with hypokalemia rather than hyperkalemia due to the effects of excess cortisol on potassium levels.
D. Bone fracture: Cushing syndrome increases the risk of osteoporosis and bone fractures due to prolonged exposure to high levels of cortisol, which affects bone density and strength.

A. Limit your intake of high sodium foods for several days after the procedure to prevent hypernatremia. B. Limit fluid intake to 1,500 mL per day for the next five days after the surgery to prevent fluid retention. C. You will need to increase your dose of corticosteroids due to the stress of surgery. D. Avoid taking hydrocortisone after the procedure due to the risk of surgical-site infection.

Correct Answer is C

Explanation

A. Limit your intake of high sodium foods for several days after the procedure to prevent hypernatremia: This is not typically recommended for clients with Addison's disease. In fact, they often need more sodium.
B. Limit fluid intake to 1,500 mL per day for the next five days after the surgery to prevent fluid retention: This is not appropriate for clients with Addison's disease. They generally need to maintain adequate hydration.
C. You will need to increase your dose of corticosteroids due to the stress of surgery: Stress, including surgery, increases the body’s need for corticosteroids in clients with Addison's disease. Therefore, increasing the dose is crucial to prevent adrenal crisis.
D. Avoid taking hydrocortisone after the procedure due to the risk of surgical-site infection: Hydrocortisone should not be avoided. It is essential for managing Addison's disease and preventing an adrenal crisis, especially under stress.

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A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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