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The nurse is caring for a patient scheduled for a thyroidectomy. Which instruction should be included in the preoperative care?

lodine will be administered in the 2 weeks before surgery to increase the level of thyroid hormone being released into the bloodstream.

Salt should be avoided during the 2 weeks before surgery.

Medications will be administered to increase the vascularity of the gland before

Medications will be administered in the 2 weeks before surgery to reduce the vascularity of the gland.

Answer and Explanation

The Correct Answer is D

A. Iodine will be administered in the 2 weeks before surgery to increase the level of thyroid hormone being released into the bloodstream: Iodine is used to reduce thyroid hormone production and decrease vascularity of the thyroid gland, not to increase it before surgery.

B. Salt should be avoided during the 2 weeks before surgery: There is no requirement to avoid salt before a thyroidectomy, and it is not part of the standard preoperative care for this procedure.

C. Medications will be administered to increase the vascularity of the gland before surgery: Increased vascularity in the thyroid gland can complicate surgery, so medications are used to decrease vascularity, not increase it.

D. Medications will be administered in the 2 weeks before surgery to reduce the vascularity of the gland: Iodine and other medications are often used to reduce the vascularity and size of the thyroid gland before surgery, which helps minimize the risk of excessive bleeding during the procedure.

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Correct Answer is D

Explanation

A. The nurse will monitor the client's blood glucose levels four (4) times a day: This is important, but it is an intervention rather than a goal. A goal should be measurable and focused on the client's outcome, such as maintaining specific glucose levels.

B. The client will demonstrate appropriate insulin injection techniques: This is a good educational goal, but it does not directly address the immediate concern. The problem states noncompliance, implying the client knows how to inject but isn't doing it consistently.

C. The client will maintain normal kidney function with 30-ml/hr urine output: While monitoring kidney function is important in diabetes, this goal does not address the immediate risk of hyperglycemia. Urine output is not the primary indicator of hyperglycemia.

D. The client will have a blood glucose level between 60-110 mg/dl at 1600: This short-term goal is specific, measurable, and time-bound. It addresses the desired outcome of maintaining blood glucose within a normal range, which addresses hyperglycemia due to noncompliance.

A. Give the client juice or hard candy immediately. B. Call the health care provider. C. Have the client lie down and see if symptoms subside. D. Assess the blood glucose level, and administer glucose in the most appropriate form.

Correct Answer is D

Explanation

A. Give the client juice or hard candy immediately: While giving juice or hard candy is an appropriate treatment for hypoglycemia, assessing the blood glucose level first is crucial to confirm that the symptoms are indeed due to low blood sugar.

B. Call the health care provider: While it's important to notify the healthcare provider if the situation worsens or if there's a concern about the client's safety, the first priority is to assess the blood glucose level and take immediate action to treat the hypoglycemia.

C. Have the client lie down and see if symptoms subside: Lying down does not address the underlying cause of hypoglycemia. The client may need glucose to raise their blood sugar levels, so this is not the most effective first action.

D. Assess the blood glucose level, and administer glucose in the most appropriate form: Assessing the blood glucose level will confirm whether the symptoms are indeed due to hypoglycemia, and then the nurse can proceed with administering glucose in the most appropriate form (such as oral glucose, juice, or glucose tablets).

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The nurse is caring for a patient scheduled for a thyroidectomy. Which instruction should be included in the preoperative care?

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