A nurse is assisting with the plan of care for a client who is 4 hr postoperative from a subtotal thyroidectomy. Which of the following implementations should the nurse recommend?

Choice A: “You shouldn’t feel any pain since the local area is anaesthetized.” This is not a response that the nurse should make to the client who is scheduled for a colonoscopy. The nurse should not tell the client that they will not feel any pain, as this may create unrealistic expectations and increase anxiety if they do experience discomfort. The nurse should also not tell the client that the local area is anaesthetized, as this is not true. The client does not receive local anesthesia for a colonoscopy, but rather sedation and pain medication.

Choice B: “Don’t worry, you won’t remember anything about the procedure due to the effects of the medication.” This is not a response that the nurse should make to the client who is scheduled for a colonoscopy. The nurse should not tell the client not to worry, as this may sound dismissive and insensitive to their concerns. The nurse should also not tell the client that they will not remember anything about the procedure, as this is not true. The client may receive conscious sedation for a colonoscopy, which means that they are awake but drowsy and relaxed. They may have some memory loss of the procedure, but they are not completely unconscious.

Choice C: “Most clients report more discomfort from the preparation than from the procedure itself.” This is not a response that the nurse should make to the client who is scheduled for a colonoscopy. The nurse should not compare the client’s experience to other clients, as this may minimize their feelings and individual differences. The nurse should also not focus on the preparation, which involves drinking a large amount of liquid laxative to empty the colon, as this may increase anxiety and dread for the client. The nurse should instead focus on providing information and support for both the preparation and the procedure.

Choice D: “You may feel some cramping during the procedure.” This is a response that the nurse should make to the client who is scheduled for a colonoscopy, which is a diagnostic test that uses a flexible tube with a camera to examine the colon and rectum. The nurse should inform the client that they may feel some cramping during the procedure as the tube is inserted and moved through the colon. The nurse should also reassure the client that they will receive sedation and pain medication to make them comfortable and relaxed.

Choice A: Palpitations. This is not a finding that the nurse should expect in a client who has a new diagnosis of hypothyroidism, but rather a sign of hyperthyroidism, which is a condition that occurs when the thyroid gland produces too much thyroid hormone. Hyperthyroidism can cause palpitations due to increased cardiac output and heart rate.

Choice B: Weight gain. This is a finding that the nurse should expect in a client who has a new diagnosis of hypothyroidism, which is a condition that occurs when the thyroid gland does not produce enough thyroid hormone. The thyroid hormone regulates the metabolism of carbohydrates, proteins, and fats, and affects energy expenditure and body temperature. Hypothyroidism can cause weight gain due to decreased metabolic rate and increased fluid retention.

Choice C: Diaphoresis. This is not a finding that the nurse should expect in a client who has a new diagnosis of hypothyroidism, but rather a sign of hyperthyroidism. Hyperthyroidism can cause diaphoresis due to increased heat production and vasodilation.

Choice D: Protruding eyeballs. This is not a finding that the nurse should expect in a client who has a new diagnosis of hypothyroidism, but rather a sign of Graves’ disease, which is an autoimmune disorder that causes hyperthyroidism. Graves’ disease can cause protruding eyeballs due to inflammation and edema of the orbital tissues and muscles.