A nurse is caring for a client on a medical-surgical unit.
A nurse is caring for a client who is postoperative following a subtotal thyroidectomy. Click to highlight the findings below that the nurse should report to the provider.
Nurses Notes
Oxygen saturation 95%
The client's voice is hoarse.
The client reports tingling around the mouth
Moderate serosanguinous drainage noted on neck dressing.
The client has a slight tremor noted in both hands.
The client's temperature has increased in 1 hr from 375° C (99.5° F) to 38.6°C (101.5 F)
The client appears restless
The client's voice is hoarse.
The client reports tingling around the mouth
Moderate serosanguinous drainage noted on neck dressing.
The client has a slight tremor noted in both hands.
The client's temperature has increased in 1 hr from 375° C (99.5° F) to 38.6°C (101.5 F)
The client appears restless
Oxygen saturation 95%
The Correct Answer is ["A","B","C","D","E","F"]
The nurse should report the hoarseness of the client's voice, which could indicate recurrent laryngeal nerve damage, which is a risk associated with thyroid surgery. Tingling around the mouth may suggest hypocalcemia, a common complication after thyroidectomy due to accidental removal or damage to the parathyroid glands. The moderate serosanguinous drainage on the neck dressing could signify bleeding or infection, which requires immediate attention. The noted tremor in both hands and the increase in temperature could be signs of a thyroid storm, a rare but life-threatening condition.
Furthermore, the client's restlessness could be a response to discomfort or could indicate a more serious issue, such as an impending thyrotoxic crisis. Oxygen saturation at 95% is within normal limits postoperatively; however, it should be monitored closely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Placing the client in Trendelenburg position is not appropriate in this situation. It may worsen respiratory depression caused by magnesium sulfate.
B. Absent deep-tendon reflexes and respiratory depression are signs of magnesium toxicity.
Discontinuing the medication infusion is essential to prevent further toxicity.
C. While preeclampsia can lead to complications necessitating emergency cesarean birth, the immediate concern here is addressing magnesium toxicity.
D. Assessing maternal blood glucose is not relevant to the management of magnesium toxicity.
Correct Answer is A
Explanation
A. Salicylate intoxication can lead to metabolic acidosis due to the accumulation of salicylic acid, which increases metabolic rate and production of organic acids.
B. Thiazide diuretics can lead to metabolic alkalosis due to the loss of hydrogen and chloride ions.
C. Vomiting can lead to metabolic alkalosis due to the loss of gastric acid.
D. Diarrhea can lead to metabolic acidosis due to the loss of bicarbonate-rich fluids.
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