The nurse is assessing a post-op thyroidectomy patient for bleeding. Which finding would indicate bleeding at the surgical site?

Complaints of pain at the incision

Increased blood pressure

Decreased white blood cell count

Presence of blood on the pillow behind the patient

Answer and Explanation

The Correct Answer is D

A.   While pain can occur post-operatively and may be a sign of complications, it is not a direct indicator of bleeding. Pain can result from normal healing, surgical trauma, or other complications, but by itself, it does not specifically point to bleeding at the surgical site.
B.   An increased blood pressure might not necessarily indicate bleeding. In some cases, blood pressure may increase due to pain, anxiety, or other factors. However, a significant drop in blood pressure would be more indicative of bleeding, especially in conjunction with other symptoms.
C.   A decreased white blood cell count (leukopenia) is not typically associated with bleeding at the surgical site. In fact, following surgery, one might expect the white blood cell count to be normal or slightly elevated due to the body’s response to surgery.
D.   This finding is indicative of bleeding at the surgical site. Blood on the pillow would suggest that there is active bleeding that has escaped from the surgical site, which is a significant concern that requires immediate assessment and intervention.

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Correct Answer is A

Explanation

A. Egg donation involves collecting eggs from a woman before undergoing fertility-compromising treatments. These eggs can then be fertilized with sperm and frozen for future use. This allows couples to have biological children after completing cancer treatment.
B. There should be no difficulty conceiving once the client is in full remission. While it is possible for some women to conceive after completing treatment for ALL, the risk of fertility problems remains. Additionally, the time it takes to achieve full remission can vary, and there is no guarantee that fertility will return to normal.
C. Encourage the couple to look into adoption once a cure is achieved. While adoption is a viable option for couples who cannot have biological children, it is important to discuss all available options with the client and her husband before they make a decision.
D. The priority at this time is beginning treatment in the hope for an eventual cure. While it is important to prioritize the treatment of ALL, it is also important to address the couple's concerns about fertility. By discussing egg donation, the nurse can help the couple make informed decisions about their future.

A. Shortness of breath, especially when lying flat B. Pain/swelling of the lymph nodes C. Low grade fevers of unknown etiology D. Drenching night sweats

Correct Answer is A

Explanation

A. A mass in the mediastinum can compress the trachea or major blood vessels, leading to shortness of breath, particularly when the patient is in a supine position (lying flat). This symptom is indicative of significant obstruction or compression, making it a key sign.
B. While lymphadenopathy (swelling of lymph nodes) is a hallmark of Hodgkin's Lymphoma, it does not specifically indicate the presence of a mediastinal mass. Lymph nodes can swell throughout the body, including cervical, axillary, and inguinal regions, but this symptom is more general and not exclusive to mediastinal involvement.
C. Low-grade fevers can occur in Hodgkin's Lymphoma due to systemic effects of the cancer, such as cytokine release. However, this symptom is nonspecific and does not directly indicate a mediastinal mass. It is more indicative of the body's response to cancer rather than localized effects.
D. Drenching night sweats are another common systemic symptom associated with Hodgkin's Lymphoma. Like low-grade fevers, night sweats are part of the B symptoms that can occur with lymphoma but are not specifically indicative of a mediastinal mass.

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The nurse is assessing a post-op thyroidectomy patient for bleeding. Which finding would indicate bleeding at the surgical site?

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