A nurse is assessing a client who had a total thyroidectomy 4 hr ago. Which of the following findings should the nurse report?

Neck stiffness

Hoarseness

Moderate serosanguineous drainage

Muscle twitching

Answer and Explanation

The Correct Answer is D

Muscle twitching can a feature of hypocalcemia which may eventually lead to tetany. It is therefore, necessary to report muscle twitching to avoid serious complications such as bronchospasm.
A.   Neck stiffness is anticipated due to manipulation of neck muscles during surgery.
B.   Hoarseness occurs due to injury of recurrent laryngeal nerve or manipulation of the vocal cords and surrounding structures during surgery.
C.   Some drainage from the incision site is expected after surgery, including a total thyroidectomy
D.   Muscle twitching may indicate neuromuscular irritability or electrolyte imbalances, which could be unrelated to the thyroidectomy surgery.

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Correct Answer is ["B","C","F","H"]

Explanation

The client has diabetes ketoacidosis (DKA) as seen in the lab findings. The management of DKA involves fluid rehydration with isotonic crystalloids such as normal saline, glycemic control with intravenous insulin infusion and electrolyte supplementation specifically potassium if it is normal or low.

This is because administration of insulin drives potassium ions into the cells leading to hypokalemia Cardiac monitoring is vital to ensure that any dysrhythmias due to electrolyte disturbances are recognized early.

Blood sugar monitoring should be done more frequently- preferably every 1 hour. Although monitoring of output is key, catheterization is unnecessary when the client is awake.

A. The client asks for help before ambulating. B. The client has a history of urinary incontinence. C. The client lives with their caregiver. D. The client has bronchitis.

Correct Answer is B

Explanation

B. Urinary incontinence can increase fall risk due to the need for frequent trips to the bathroom, which may increase the chances of tripping or falling, especially if the client rushes to the bathroom.
A. This indicates that the client is aware of their limitations and is proactive in seeking assistance, which may actually decrease their fall risk. It demonstrates awareness and caution.
C. While having a caregiver present can provide support and assistance, it doesn't necessarily indicate an increased fall risk. In fact, having a caregiver present may decrease the risk of falls by providing supervision and assistance as needed.
D. Bronchitis itself does not directly contribute to an increased fall risk.

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A nurse is assessing a client who had a total thyroidectomy 4 hr ago. Which of the following findings should the nurse report?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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