Question

The client has recently returned from having a thyroidectomy. The nurse should keep which of the following at the bedside? A. A tracheotomy set B. A padded tongue blade C. An endotracheal tube D. An airway

Short answer

Answer: A tracheotomy set

Step-by-step solution

Understand the implications of a thyroidectomy

A thyroidectomy is a surgical procedure in which a portion or the entire thyroid gland is removed. This procedure can lead to complications related to airway management, as the thyroid gland is located in the neck near the trachea and larynx.

Evaluate Option A (A tracheotomy set)

A tracheotomy set is a medical equipment used to perform a tracheotomy, which involves creating an opening in the trachea to establish an airway. This can be an important lifesaving procedure in case of airway obstruction due to postoperative complications. Therefore, this seems like a relevant option for a thyroidectomy patient.

Evaluate Option B (A padded tongue blade)

A padded tongue blade is a device used to depress the tongue for examination of the oral cavity or to prevent tongue biting during a seizure. This item is not directly relevant to the complications and needs of a thyroidectomy patient.

Evaluate Option C (An endotracheal tube)

An endotracheal tube is a flexible plastic tube that is placed through the mouth or nose into the trachea to help a patient breathe. This might be useful during the surgery, but it is generally removed before the patient regains consciousness. Thus, it would not be necessary to keep at the patient's bedside after the surgery.

Evaluate Option D (An airway)

An airway, also known as an oropharyngeal airway, is a curved plastic tube used to maintain an open airway during resuscitation or anesthesia. These are generally used during surgery or cardiopulmonary arrest situations and are not specifically related to postoperative care of clients who had a thyroidectomy.

Compare the options and choose the best one

Considering the potential complications of a thyroidectomy, having a tracheotomy set at the bedside is the most relevant and potentially lifesaving option, as it can be used in case of airway obstruction. The other options do not directly address the specific needs and potential complications of a client who has recently had a thyroidectomy. Therefore, the correct answer is: A. A tracheotomy set

Key concepts

Nursing Procedures

Nursing procedures encompass a wide variety of tasks and responsibilities that nurses carry out to ensure the safety and well-being of patients. These procedures can range from simple tasks, such as taking a patient's vital signs, to more complex interventions like administering medication or supporting surgical recovery.

In the context of thyroidectomy, specific nursing procedures are crucial to monitor and manage potential complications.

• Nurses assess a patient's airway and make sure it's clear to prevent respiratory distress.
• They also monitor the patient's vital signs closely to catch any early signs of complications.

Nursing procedures in postoperative settings aim to create a seamless recovery process, ensuring patient's needs are met promptly and efficiently. These procedures help manage pain, prevent infections, and support overall healing.

Postoperative Care

Postoperative care involves a set of activities aimed at addressing a patient's needs after surgery.
It includes monitoring physiological functions and managing pain to facilitate a smooth recovery.
After a thyroidectomy, patients may face significant changes and risks due to the proximity of the surgery to the airway and vital neck structures.

Key elements of postoperative care for thyroidectomy patients include:

• Close observation for signs of airway obstruction such as difficulty breathing or abnormal throat sensations.
• Regular monitoring of vital signs to detect any changes that could indicate complications.
• Assessment for signs of hemorrhage or swelling in the neck area, which can compromise airway patency.

Postoperative care is essential to ensure that any emerging issues are promptly managed to reduce the risk of serious complications.

Airway Management

Airway management is critical in post-thyroidectomy care due to the proximity of surgery to the airway structures. Effective airway management ensures that the patient maintains adequate ventilation and oxygenation, which are vital for recovery.

After surgery, the risk of airway obstruction can be significant, hence:

• Nurses need to be vigilant for signs of airway compromise, such as swelling or bleeding.
• A tracheotomy set should be readily available as a precautionary measure to provide an emergency airway if needed.

Without effective airway management, a patient could rapidly deteriorate, highlighting its importance in the context of surgical recovery. Maintaining an open airway is central to avoiding potential postoperative complications.

Surgical Complications

Any surgical procedure, including thyroidectomy, carries the risk of complications. These can range from minor to severe and require careful monitoring and skillful intervention by healthcare professionals.

Potential complications following a thyroidectomy include:

• Hemorrhage, which can cause neck swelling and impact breathing.
• Infection at the surgical site, which requires prompt treatment to avoid systemic involvement.
• Thyroid storm, although rare, is a life-threatening condition that requires immediate medical attention.

Identifying surgical complications early is crucial for preventing further deterioration in the patient's health. A prepared and swift response is needed to manage these complications effectively for positive patient outcomes.