A nurse is teaching a newly licensed nurse about wearing medical masks. Which of the following statements should the nurse include?

A. A decrease in systolic blood pressure from 140 mm Hg to 120 mm Hg could indicate hypotension. Postoperatively, especially after receiving a spinal anesthetic, hypotension can occur due to vasodilation or decreased sympathetic tone. This change in blood pressure warrants notification of the provider because significant hypotension can lead to inadequate perfusion to vital organs and tissues.
B. A slight increase in temperature from 37.2°C to 37.5°C (99.0°F to 99.5°F) is a mild elevation and may not necessarily require immediate notification unless accompanied by other signs of infection or instability. It could be related to the stress response post-surgery. However, if there are other concerning signs (e.g., increased heart rate, worsening pain), the nurse should reassess and consider further action.

C. A decrease in pulse oximetry from 98% to 96% indicates a mild decrease in oxygen saturation. While this change alone may not be alarming, the nurse should assess the client's respiratory status and potential causes (e.g., positioning, respiratory depression from anesthesia). Oxygen saturation levels below 95% generally require intervention, but 96% is still within a normal range for most clients.
D. An increase in pain from 4/10 to 6/10 indicates worsening pain. Postoperatively, increasing pain may indicate inadequate pain management, worsening condition at the surgical site, or other complications such as hematoma or infection.

Correct choices are:

Hoarse voice

A hoarse voice can indicate injury or irritation to the recurrent laryngeal nerve, which is a common complication following thyroid surgery. This nerve is located near the thyroid gland and can be affected during thyroidectomy, leading to vocal cord dysfunction. It's important to report this change in voice to the provider for further evaluation and management.

Tingling around the mouth

Tingling around the mouth can be a sign of hypocalcemia, which is a potential complication after thyroidectomy due to inadvertent damage or removal of the parathyroid glands. These glands regulate calcium levels in the body. Hypocalcemia can present with symptoms such as tingling, numbness, and muscle spasms. Prompt reporting is necessary so that calcium levels can be assessed and appropriate treatment initiated if needed.

Temperature increase from 37.5°C (99.5°F) to 38.6°C (101.5°F) within 1 hour

A rapid increase in temperature postoperatively may indicate infection, such as surgical site infection or systemic infection. This is particularly concerning given the recent surgical procedure. Reporting this change in temperature promptly allows the provider to assess for signs of infection, order appropriate diagnostic tests (such as blood cultures or wound cultures), and initiate timely treatment.

Moderate serosanguinous drainage noted on neck dressing

Serosanguinous drainage (clear to slightly bloody fluid) on the neck dressing is expected post- thyroidectomy, but the amount and nature of drainage should be assessed regularly for any signs of excessive bleeding or infection. Reporting moderate drainage ensures that the provider can assess for complications, such as hematoma formation or wound infection, and intervene as necessary.