While assessing a patient who has just arrived in the post-anesthesia recovery unit (PACU) after a thyroidectomy, the nurse obtains this data. Which is the most important to communicate to the surgeon?
The patient’s voice is weak and hoarse sounding.
The patient is complaining of a 7/10 incisional pain.
The patient’s cardiac monitor shows a heart rate of 112.
The patient is increasingly swelling at the neck.
The Correct Answer is D
This is a critical finding that could indicate bleeding or compromised airway, both of which are potentially life-threatening complications following a thyroidectomy. Immediate intervention may be necessary to prevent further harm to the patient. The other options are important to note and should be addressed, but they do not require immediate intervention as the swelling in the neck does.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Coffee-ground material in the NG suction indicates that there is active bleeding in the upper gastrointestinal tract, which could be a life-threatening situation. This requires immediate medical attention and intervention to control the bleeding and stabilize the patient.
Options A, B, and C are also important assessment data, but they are not as urgent as option D in this scenario.
Correct Answer is C
Explanation
The operating room is a sterile environment, and it is critical to maintain a clean and controlled environment to reduce the risk of infection to the patient. The measures taken include maintaining positive air pressure, controlling temperature and humidity, filtering the air, using sterile surgical instruments, and limiting traffic in and out of the operating room. These measures help to prevent the spread of infectious agents that may be present in the operating room. While the other options (a, b, and d) may also be important considerations in the design of the operating room, preventing transmission of infection is the primary goal.
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