What is the most crucial nursing intervention to include in the care plan for a patient who is 12 hours post- thyroidectomy?
Anticipate and monitor for hypothermia.
Prepare to administer radioactive iodine treatments.
Resume antithyroid drug therapy.
Maintain a semi-Fowler position.
The Correct Answer is A
Choice A rationale
Anticipating and monitoring for hypothermia is the most crucial nursing intervention to include in the care plan for a patient who is 12 hours post-thyroidectomy. The thyroid gland plays a significant role in regulating the body’s metabolism, including temperature regulation. After a thyroidectomy, the body may struggle to regulate temperature, leading to hypothermia. The nurse should monitor the patient’s temperature regularly and provide warming measures as needed.
Choice B rationale
Preparing to administer radioactive iodine treatments is not the most crucial intervention at this time. Radioactive iodine is typically used as a treatment for hyperthyroidism or thyroid cancer, not as an immediate post-operative intervention.
Choice C rationale
Resuming antithyroid drug therapy is not the most crucial intervention at this time. Antithyroid drugs are used to treat hyperthyroidism, and their use would need to be evaluated based on the reason for the thyroidectomy and the patient’s post-operative thyroid hormone levels.
Choice D rationale
Maintaining a semi-Fowler position can be beneficial for comfort and respiratory function post-operatively, but it is not the most crucial intervention. The nurse should assist the patient to a comfortable position and encourage regular deep breathing and coughing exercises to prevent respiratory complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Hyperventilation leads to a decrease in the amount of carbon dioxide (CO2) in the blood. This causes the pH of the blood to increase, resulting in respiratory alkalosis.
Choice B rationale
Respiratory acidosis is caused by a buildup of CO2 in the blood, typically due to hypoventilation (under-breathing). This is not consistent with the patient’s symptoms of hyperventilation.
Choice C rationale
Metabolic alkalosis is typically caused by a significant loss of acid from the body, such as from prolonged vomiting. This is not consistent with the patient’s symptoms.
Choice D rationale
Metabolic acidosis is typically caused by an increase in acid production within the body or a loss of bicarbonate from the body, such as in diabetic ketoacidosis or kidney disease. This is not consistent with the patient’s symptoms.
Correct Answer is ["C","D","E"]
Explanation
Choice A rationale
Chills and fever are not typically associated with preeclampsia. They are more commonly seen in infections.
Choice B rationale
Lack of appetite is a non-specific symptom and can be associated with many conditions, but it is not a key indicator of preeclampsia.
Choice C rationale
Swollen hands can be a symptom of preeclampsia. This condition can cause sudden weight gain and swelling (edema), particularly in your face and hands.
Choice D rationale
Headaches are a common symptom of preeclampsia. They are often severe and may be accompanied by changes in vision.
Choice E rationale
Blurred vision is a symptom of preeclampsia. Other vision changes, such as sensitivity to light or temporary loss of vision, can also occur.
Choice F rationale
Frequent urination is not typically associated with preeclampsia. It is a common symptom in early and late pregnancy due to the growing uterus pressing on the bladder.
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