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 D
Explanation
A. Constipation is not typically associated with hypocalcemia.
B. Shortened QT intervals are not characteristic of hypocalcemia; rather, prolongation of QT intervals is more common.
C. Hypoactive deep tendon reflexes, would suggest a decrease in neuromuscular excitability, which is contrary to the increased excitability seen in hypocalcemia. Therefore, hypoactive deep tendon reflexes is more commonly associated with hypercalcemia and not hypocalcemia.
D. Tingling of the extremities is a common symptom of hypocalcemia.
Correct Answer is B
Explanation
A. Wheezing is not typically associated with hyperkalemia. It can be seen in conditions such as asthma or chronic obstructive pulmonary disease (COPD).
B. Hyperkalemia can lead to neuromuscular manifestations, including decreased deep tendon reflexes due to suppression of neuromuscular excitability.
C. Cerebral edema is not a typical manifestation of hyperkalemia. It may occur in conditions such as hyponatremia or severe metabolic acidosis.
D. Gastrointestinal manifestations of hyperkalemia are typically related to smooth muscle involvement and can include hyperactive bowel sounds or diarrhea.
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