A nurse is caring for a client on a medical-surgical unit.
A nurse is caring for a client who is postoperative following a subtotal thyroidectomy. Click to highlight the findings below that the nurse should report to the provider.
Nurses Notes
Oxygen saturation 95%
The client's voice is hoarse.
The client reports tingling around the mouth
Moderate serosanguinous drainage noted on neck dressing.
The client has a slight tremor noted in both hands.
The client's temperature has increased in 1 hr from 375° C (99.5° F) to 38.6°C (101.5 F)
The client appears restless
The client's voice is hoarse.
The client reports tingling around the mouth
Moderate serosanguinous drainage noted on neck dressing.
The client has a slight tremor noted in both hands.
The client's temperature has increased in 1 hr from 375° C (99.5° F) to 38.6°C (101.5 F)
The client appears restless
Oxygen saturation 95%
The Correct Answer is ["A","B","C","D","E","F"]
The nurse should report the hoarseness of the client's voice, which could indicate recurrent laryngeal nerve damage, which is a risk associated with thyroid surgery. Tingling around the mouth may suggest hypocalcemia, a common complication after thyroidectomy due to accidental removal or damage to the parathyroid glands. The moderate serosanguinous drainage on the neck dressing could signify bleeding or infection, which requires immediate attention. The noted tremor in both hands and the increase in temperature could be signs of a thyroid storm, a rare but life-threatening condition.
Furthermore, the client's restlessness could be a response to discomfort or could indicate a more serious issue, such as an impending thyrotoxic crisis. Oxygen saturation at 95% is within normal limits postoperatively; however, it should be monitored closely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. 0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution with a lower concentration of sodium than normal serum levels. It can help to lower the sodium levels in a client with hypernatremia by diluting the excess sodium in the body.
B. Dextrose 10% in water is hypertonic and not appropriate for a client with hypernatremia, as it could exacerbate the imbalance.
C. Lactated Ringer's is isotonic and contains sodium in a similar concentration to serum levels, hence it could further increase the sodium levels.
D. Dextrose 5% in 0.9% sodium chloride (also known as D5NS) is a hypertonic solution that contains both dextrose and sodium. It would not be appropriate for a client with hypernatremia, as it could exacerbate the condition.
Correct Answer is B
Explanation
A. Increasing sodium intake is generally not recommended in chronic kidney disease, as it can exacerbate hypertension and fluid retention.
B. Epoetin alfa is a medication used to treat anemia associated with chronic kidney disease, and iron supplementation is often necessary to support erythropoiesis.
C. Potassium intake may need to be restricted in chronic kidney disease, especially in later stages when kidney function declines.
D. Protein intake may need to be adjusted in chronic kidney disease, but it's not directly related to the prescription of epoetin alfa.
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