A nurse should identify which of the following as ways to make a positive impact in reducing health disparities in the clients they care for?

A. The water temperature for handwashing should be comfortable and tolerable for the hands. Hot water can be drying to the skin and may not necessarily improve the effectiveness of hand hygiene. Ideally, the water temperature should be warm, but not uncomfortably hot or cold, to encourage thorough handwashing.
B. The amount of soap used for handwashing is important for effective cleaning. Applying 4 to 5 mL (approximately a teaspoon) of liquid soap ensures adequate coverage to create lather and effectively cleanse the hands. Too little soap may not produce enough lather to clean effectively, while too much may be wasteful.
C. During hand hygiene, it's recommended to keep the hands lower than the elbows to prevent water from running from the contaminated area (hands) to the cleaner area (elbows). This helps maintain hygiene and prevents potential contamination of the cleaned hands.
D. After washing hands with soap and water, it's important to dry them thoroughly. However, rubbing hands and arms to dry is not recommended. Instead, hands should be dried using a clean towel or paper towel. Rubbing can cause friction and potential irritation to the skin.

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.