Question

The client returns from surgery following a thyroidectomy. Which action by the nurse indicates understanding of the needs of the client that has a thyroidectomy? A. The nurse checks the urinary output hourly. B. The nurse places a tracheostomy set at the bedside. C. The nurse offers pain medication every hour. D. The nurse checks the abdominal dressing.

Short answer

Answer: B. The nurse places a tracheostomy set at the bedside.

Step-by-step solution

Option A: The nurse checks the urinary output hourly.

Checking the patient's urinary output hourly is crucial in various surgical procedures, especially when there is a concern about fluid balance or kidney function. However, this is not specific to patients who have had thyroidectomy and does not indicate the nurse's understanding of the needs of such patients.

Option B: The nurse places a tracheostomy set at the bedside.

Following a thyroidectomy, there is a potential risk of airway compromise due to postoperative swelling or bleeding, which may lead to respiratory distress. Keeping a tracheostomy set at the bedside ensures that emergency equipment is immediately available if the patient develops difficulty breathing. This action indicates understanding of the specific needs of a patient post-thyroidectomy.

Option C: The nurse offers pain medication every hour.

Although adequate pain management is essential for all postoperative patients, offering pain medication every hour is not particular to the care of a thyroidectomy patient. This action does not indicate an understanding of the specific needs for a patient who has had a thyroidectomy.

Option D: The nurse checks the abdominal dressing.

Since a thyroidectomy is a surgical procedure involving the neck and not the abdomen, checking an abdominal dressing is not relevant to the post-operative care of a patient who has had a thyroidectomy. This action does not indicate understanding of the specific needs of such a patient. Based on the analysis of each option, the correct answer is: B. The nurse places a tracheostomy set at the bedside.

Key concepts

Postoperative Nursing Care

After a thyroidectomy, postoperative nursing care plays a vital role in supporting the patient's recovery process. Nurses must focus on several key areas to ensure effective care. Proper monitoring and timely interventions can prevent complications and promote healing. Here are some essential aspects:

• Pain Management: Although pain management is not the most crucial aspect immediately after a thyroidectomy, it still requires attention. Administering the right dosage of pain medication when necessary ensures patient comfort.
• Positioning: It's important to keep the patient's head elevated. This will help reduce swelling around the neck area and ensure comfort.
• Monitoring Vital Signs: Regular checks of vital signs, such as blood pressure, heart rate, and respirations, alert nurses to potential complications.
• Assess for Signs of Hemorrhage: Since the surgery site is in a highly vascular area, watch for any signs of bleeding.

Postoperative care for a thyroidectomy requires understanding specific medical and physical needs unique to this type of surgery. Nurses are trained to anticipate these requirements, reducing potential risks and fostering a safe recovery.

Patient Safety

Ensuring patient safety after a thyroidectomy is a top priority. This surgery carries specific risks due to its proximity to vital structures in the neck. It's crucial to take steps that protect the patient from harm while promoting a smooth recovery. Key safety measures include:

• Immediate Accessibility to Emergency Equipment: Having a tracheostomy set at the bedside is an important precaution. It ensures quick intervention if airway obstruction occurs due to swelling or bleeding.
• Prevent Falls: Due to possible lightheadedness or medication effects, ensuring the patient has support when moving is important to prevent falls.
• Infection Control: Maintaining cleanliness around the surgical site and practicing good hygiene helps prevent infections.

Patient safety measures are about being proactive and vigilant. Nurses face the challenge of identifying potential complications early and taking preventive steps to avoid them.

Airway Management

One of the critical concerns after a thyroidectomy is maintaining a clear and stable airway. Since the surgery is close to the trachea, any swelling or bleeding can compromise the airway, posing a serious risk. Effective airway management includes several proactive steps:

• Observation for Respiratory Distress: Close monitoring of the patient's breathing patterns is essential. Any signs of difficulty or changes in respiratory rate require immediate attention.
• Emergency Preparedness: Always keep a tracheostomy set and other airway management tools readily available.
• Maintaining Airway Patency: Ensure the patient is positioned properly with the head elevated, which aids breathing and reduces the risk of airway obstruction.

Supporting the airway post-thyroidectomy is not only about being prepared for emergencies. It also involves nurturing an environment where potential risks are minimized, ensuring smoother respiration for the patient.