A nurse is teaching a newly licensed nurse about wearing medical masks. Which of the following statements should the nurse include?

A. Episodes of confusion could indicate various issues, such as metabolic disturbances, disease progression affecting the central nervous system, or medication side effects. However, confusion alone would not typically lead to an increase in morphine dosage. Therefore, this is not a likely explanation for why the client needed more morphine for pain relief.
B. Tolerance occurs when the body adapts to the effects of a medication over time, requiring higher doses to achieve the same therapeutic effect. This is a common phenomenon with opioids like morphine when used long-term for pain management. If the client's pain relief diminished despite increasing the dose, tolerance to morphine could indeed be the reason why higher doses were needed.
C. Addiction is a psychological and physiological dependence on a substance characterized by compulsive drug-seeking behavior and use despite harmful consequences. Addiction is not typically the reason why a client with terminal cancer would require an increased dose of morphine for pain relief. In this context, the focus is on managing pain rather than addiction.
D. If the client has not been adhering to the prescribed dosing schedule or has missed doses, it could result in inadequate pain control. This might necessitate an increase in morphine dosage to achieve adequate pain relief. However, this scenario would require further assessment to confirm.

Correct choices are:

Hoarse voice

A hoarse voice can indicate injury or irritation to the recurrent laryngeal nerve, which is a common complication following thyroid surgery. This nerve is located near the thyroid gland and can be affected during thyroidectomy, leading to vocal cord dysfunction. It's important to report this change in voice to the provider for further evaluation and management.

Tingling around the mouth

Tingling around the mouth can be a sign of hypocalcemia, which is a potential complication after thyroidectomy due to inadvertent damage or removal of the parathyroid glands. These glands regulate calcium levels in the body. Hypocalcemia can present with symptoms such as tingling, numbness, and muscle spasms. Prompt reporting is necessary so that calcium levels can be assessed and appropriate treatment initiated if needed.

Temperature increase from 37.5°C (99.5°F) to 38.6°C (101.5°F) within 1 hour

A rapid increase in temperature postoperatively may indicate infection, such as surgical site infection or systemic infection. This is particularly concerning given the recent surgical procedure. Reporting this change in temperature promptly allows the provider to assess for signs of infection, order appropriate diagnostic tests (such as blood cultures or wound cultures), and initiate timely treatment.

Moderate serosanguinous drainage noted on neck dressing

Serosanguinous drainage (clear to slightly bloody fluid) on the neck dressing is expected post- thyroidectomy, but the amount and nature of drainage should be assessed regularly for any signs of excessive bleeding or infection. Reporting moderate drainage ensures that the provider can assess for complications, such as hematoma formation or wound infection, and intervene as necessary.