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 B
Explanation
A. Constipation is more commonly associated with hypothyroidism, not hyperthyroidism.
B. Hyperthyroidism can lead to emotional lability, anxiety, and irritability due to increased metabolic rate.
C. Weight loss is a common manifestation of hyperthyroidism, not weight gain.
D. Sensitivity to cold is more commonly associated with hypothyroidism, not hyperthyroidism.
Correct Answer is B
Explanation
A. Polyuria (excessive urination) is not typically associated with low calcium levels. It may occur in conditions such as diabetes mellitus or diabetes insipidus.
B. Hypocalcemia (low calcium levels) can lead to neuromuscular irritability, which may manifest as muscle tremors or spasms. This is a classic sign of hypocalcemia.
C. Dry, sticky mucous membranes are more indicative of dehydration rather than hypocalcemia.
D. Negative Chvostek's sign means the absence of facial muscle twitching upon tapping the facial nerve, which is not expected in hypocalcemia.
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