The complication of diabetic neuropathy places the client at risk for which of these conditions?

Choice A rationale: A complete thyroidectomy removes the thyroid gland, which is responsible for producing calcitonin, a hormone that regulates calcium levels. While some clients may experience temporary hypocalcemia post-surgery due to parathyroid gland manipulation, long-term calcium replacement is not always required. The parathyroid glands, if left intact, regulate calcium homeostasis.
Choice B rationale: A complete thyroidectomy necessitates lifelong thyroid hormone replacement therapy. Without the thyroid gland, the body cannot produce triiodothyronine (T3) and thyroxine (T4), which are essential for regulating metabolism, growth, and development. Failure to replace these hormones would lead to severe hypothyroidism.
Choice C rationale: As the entire thyroid gland is removed, the body's natural source of thyroid hormones is gone. Therefore, the client will require daily exogenous thyroid hormone supplementation, such as levothyroxine, for the rest of their life to maintain metabolic function and prevent the symptoms of hypothyroidism.
Choice D rationale: Postoperative pain management is a standard component of care following any surgical procedure, including a thyroidectomy. The client should be encouraged to report pain and receive appropriate medication to ensure comfort, promote healing, and facilitate early ambulation and recovery.

Choice A rationale: Tetany is a neuromuscular hyperexcitability disorder caused by hypocalcemia, which can be a complication of a thyroidectomy due to accidental removal or damage to the parathyroid glands. Symptoms include tingling sensations, muscle spasms, and carpopedal spasms. While a possible post-surgical complication, the client’s signs of high temperature, tachycardia, and restlessness point to a different, more severe condition.
Choice B rationale: Hypoglycemia is a state of low blood glucose, typically below 70 mg/dL. Symptoms include sweating, shakiness, confusion, and hunger. The client’s signs of a high temperature, tachycardia, and extreme restlessness are not classic symptoms of hypoglycemia. Furthermore, hypoglycemia is not typically a complication of a thyroidectomy unless the client has a pre-existing diabetic condition.
Choice C rationale: A thyroid crisis, or thyroid storm, is a life-threatening complication of hyperthyroidism that can be precipitated by surgery, particularly a thyroidectomy, in an inadequately prepared client. It is characterized by a massive release of thyroid hormones, leading to a hypermetabolic state with symptoms including extremely high fever, severe tachycardia, altered mental status, and cardiovascular collapse. The client's symptoms are classic signs of this condition.
Choice D rationale: Diabetic ketoacidosis (DKA) is a severe complication of uncontrolled diabetes mellitus characterized by hyperglycemia, metabolic acidosis, and ketone body production. Symptoms include fruity breath, abdominal pain, and Kussmaul respirations. A thyroidectomy is not a direct cause of DKA. The client’s signs and symptoms, particularly the very high temperature, are not typical of DKA.