A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan?

Place the head of the client's bed in the flat position.

Instruct the client to deep breathe every 4 hr.

Hyperextend the client's neck.

Check the client's voice every 2 hr.

Answer and Explanation

The Correct Answer is D

- Choice A Rationale: Placing the head of the bed in the flat position is not recommended as it can increase the risk of airway obstruction and reduce venous drainage from the head, which is especially critical after thyroid surgery.
- Choice B Rationale: While deep breathing is important postoperatively, it is not specific to thyroidectomy care and should be done more frequently than every 4 hours to ensure adequate ventilation and prevent atelectasis.
- Choice C Rationale: Hyperextending the client's neck can be harmful post-thyroidectomy as it may put stress on the surgical site, potentially leading to dehiscence or damage to the area.
- Choice D Rationale: Checking the client's voice every 2 hours is essential after a thyroidectomy because vocal cord paralysis can be an indicator of recurrent laryngeal nerve damage, which is a potential complication of the surgery. Monitoring the voice allows for early detection and intervention.

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Correct Answer is A

Explanation

A. Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg - This combination of severe hypokalemia (low potassium) and elevated blood pressure is a concerning finding. It can lead to serious cardiac complications and requires immediate attention.

B. Serum phosphorus 3 mg/dL and hirsutism - While low serum phosphorus may be seen in Cushing syndrome, it is not an immediate concern. Hirsutism (excessive hair growth) is a characteristic feature of Cushing syndrome.

C. Serum calcium 10 mg/dL, and reports of feelings of depression - Although an elevated serum calcium level is not typical in Cushing syndrome, it is not an immediate concern. Reports of depression should be addressed but do not require immediate follow-up.

D. Serum sodium 145 mEq/L and reports of muscle weakness - These findings are not indicative of immediate danger. Elevated serum sodium and muscle weakness can occur in Cushing syndrome, but they do not warrant immediate attention compared to the potassium level and blood pressure in option A.

A. Thyroid stimulating hormone (TSH) B. Prolactin C. Oxytocin D. Gonadotropin hormones E. Adrenocorticotropic hormone (ACTH)

Correct Answer is ["A","B","D","E"]

Explanation

A. Thyroid stimulating hormone (TSH): The anterior pituitary gland secretes TSH, which regulates the thyroid gland's function. Surgery on the anterior pituitary can potentially disrupt the production and regulation of TSH.

B. Prolactin: The anterior pituitary gland also produces prolactin. Surgery on the anterior pituitary can affect prolactin production.

C. Oxytocin: Oxytocin is produced by the posterior pituitary, not the anterior pituitary. Surgery on the anterior pituitary would not directly impact oxytocin production.

D. Gonadotropin hormones: These include follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are important for reproductive function. The anteriorpituitary secretes these hormones, so surgery on the anterior pituitary can impact their production.

E. Adrenocorticotropic hormone (ACTH): ACTH is essential for the stimulation of cortisol release from the adrenal glands. The production of ACTH is regulated by the anterior pituitary, so surgery in this area can affect ACTH levels.

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A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan?

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Correct Answer is A

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Correct Answer is ["A","B","D","E"]

Explanation

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