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Thyroidectomy (17 Questions)
1.1 Ms. Isabelle Marchand is recovering on the surgical unit after a total thyroidectomy performed earlier today. Her surgery went smoothly, and she is currently stable with an IV running at maintenance rate and receiving postoperative monitoring.
Two hours into your shift, you notice intermittent muscle twitching, and Ms. Marchand reports numbness and tingling around her lips, fingers, and toes.
Question:
What do you suspect is happening to the patient?
*
She is developing a thyroid storm
She is experiencing hypocalcemia
She is having a reaction to anesthesia
She is experiencing early signs of a stroke
1.2 Given her numbness, tingling, and muscle twitching. You immediately notify the physician. The physician gives a verbal order.
Medical orders:
*Draw serum calcium and magnesium levels STAT
*Administer calcium gluconate 1 g IV over 10 minutes if symptomatic
*Monitor cardiac rhythm continuously
Question:
What is your next priority intervention?
*
Prepare to administer IV calcium gluconate
Check the patient’s vital signs
Elevate the head of the bed to 90 degrees
Offer the patient warm fluids to relieve tingling
1.3 Ms. Marchand continues to speak in a strained and weak voice. She appears frustrated and tries to express herself, but speaking seems difficult. You want to ensure she can still communicate effectively while her voice is recovering.
Question:
What is the most appropriate nursing action to facilitate communication with Ms. Marchand?
*
Encourage the patient to keep trying to speak clearly
Offer the patient a pen and paper
Reassure the patient that this is expected and leave the room
Tell the patient to whisper instead of speaking out loud
1.4 Ms. Marchand is being discharged home following her thyroidectomy. Before leaving, she asks what she should and shouldn’t do during her recovery at home.
Question:
What advice will you give her to support a safe and effective recovery? Choose TWO (2) answers
*
Resume a diet rich in seafood to support thyroid function
Avoid lifting heavy objects for several days
Whisper when speaking to avoid straining the voice
Avoid driving until cleared by the physician
1.5 During her follow up visit, she admits to stopping her Synthroid (levothyroxine) for the past two months.
She appears withdrawn, tearful, and expresses suicidal thoughts.
She also mentions that her boyfriend broke up with her on Facebook.
Question:
What do you suspect is happening to Ms. Marchand?
*
She is experiencing a situational emotional crisis due to the breakup.
She is having a panic attack triggered by social stress.
She is in a severe hypothyroid state affecting her mental status.
She is demonstrating manipulative behavior to gain attention.
2. Mme. Ginette Roy, 45 years old, is 2 hours post-total thyroidectomy. She presses the call bell urgently. When the nurse enters, Mme. Roy is sitting on the side of the bed, appearing terrified and gasping for air. Upon auscultation, the nurse hears high-pitched, harsh sounds (stridor) on inspiration. There is swelling noted at the anterior neck.
Medical Orders:
*Head of Bed (HOB) elevated 30-45 degrees.
*Vital signs q15min.
*Tracheostomy tray at bedside.
*Calcium Gluconate IV PRN.
Question:
What is the nurse’s priority action?
*
Administer Calcium Gluconate IV immediately.
Prepare for emergency tracheostomy.
Apply an ice pack to the neck to reduce edema.
Encourage the patient to cough and deep breathe.
3. M. Pierre Tremblay, 55 years old, is 24 hours post-total thyroidectomy. During the morning assessment, he complains to the nurse that his lips feel numb and tingling, and his fingertips feel "pins and needles." He is restless.
Medical Orders:
*Regular diet.
*Calcium Carbonate PO BID.
*Calcium Gluconate 10% IV PRN.
*Monitor for signs of hypocalcemia.
Question:
What is the nurse’s priority intervention?
*
Administer the oral Calcium Carbonate with his breakfast.
Encourage him to breathe into a paper bag.
Prepare to administer IV Calcium Gluconate.
Check his oxygen saturation level.
4. Mme. Lise Gagnon, 38 years old, is recovering from a subtotal thyroidectomy. While the nurse is measuring her blood pressure, the cuff is inflated above the systolic pressure. Suddenly, Mme. Gagnon’s hand flexes inward (carpal spasm) and she cannot voluntarily relax it.
Medical Orders:
*Vital signs q4h.
*Serum Calcium levels daily.
Question:
How should the nurse document this finding?
*
Positive Babinski reflex.
Positive Trousseau’s sign.
Positive Chvostek’s sign.
Post-operative seizure activity.
5. M. Robert Bouchard, 29 years old, had a thyroidectomy for Graves' Disease (Hyperthyroidism) 6 hours ago. He suddenly becomes extremely agitated and confused.
Assessment:
*Temperature: 40.1°C.
*Heart Rate: 135 bpm (tachycardia).
*BP: 160/95 mmHg.
*Skin: Hot and flushed.
Medical Orders:
*Acetaminophen 650 mg PO/PR q4h PRN for fever.
*Notify MD for Temp > 38.5°C or HR > 120.
*Propranolol IV PRN.
Question:
What condition should the nurse suspect?
*
Malignant Hyperthermia from anesthesia.
Post-operative wound infection.
Thyroid Storm (Thyrotoxicosis).
Hypovolemic shock.
6. Mme. Claire Turcotte, 62 years old, returns to the unit post-thyroidectomy. She is drowsy but follows commands. The nurse is positioning her in bed to ensure safety and comfort.
Medical Orders:
*Bed rest with bathroom privileges.
*Support head and neck with pillows.
*Ice pack to incision PRN.
Question:
What is the most appropriate position?
*
Supine (flat) with a small pillow under the neck to hyperextend the neck.
Semi-Fowler’s (30-45 degrees) with the head supported in a neutral position.
High-Fowler’s (90 degrees) with the head turned to the side to drain secretions.
Side-lying to prevent aspiration.
7. M. Jean-Paul Cote, 50 years old, is 4 hours post-op. He complains of a sensation of "fullness" or pressure in his neck. The nurse inspects the anterior dressing and notes it is dry and intact with only a scant amount of serosanguinous drainage.
Medical Orders:
*Monitor dressing for bleeding.
*Vital signs q1h.
Question:
What is the nurse’s next action?
*
Document the findings as normal; the dressing is dry.
Loosen the dressing to relieve the pressure.
Check behind the patient’s neck and shoulders for pooling blood.
Administer an analgesic for the discomfort.
9. M. Michel Fortin, 60 years old, had a Total Thyroidectomy for cancer. He is preparing for discharge. He asks the nurse, "How long will I have to take this Levothyroxine (Synthroid) pill?"
Medical Orders:
*Discharge home.
*Levothyroxine 100 mcg PO daily.
*Follow up TSH levels in 6 weeks.
Question:
What is the correct nursing response?
*
"You will take it until your thyroid grows back, usually about 6 months."
"You only need to take it when you feel tired or cold."
"You will take it for 2 weeks to help with healing, then stop."
"You will need to take this medication for the rest of your life because your body no longer produces thyroid hormone."
10. The nurse is preparing the room to receive Mme. Valérie Desjardins, who is currently in the PACU following a thyroidectomy. The nurse ensures the bed is in the correct position and organizes the bedside table.
Medical Orders:
*Post-op Thyroidectomy protocol.
Question:
Which specific safety equipment must be available at the bedside before the patient arrives?
*
A defibrillator and ECG monitor.
A Tracheostomy set, suction equipment, and oxygen.
A chest tube insertion tray.
A nasogastric tube and lavage kit.
11. M. Sylvain Lapointe, 35 years old, is being discharged. He is concerned about the appearance of his scar on his neck.
Medical Orders:
*Discharge instructions.
*No heavy lifting.
Question:
Which instruction should the nurse provide to minimize scarring and protect the incision?
*
"Apply heating pads to the neck every night to soften the skin."
"Keep the neck completely immobile/stiff for 2 weeks."
"Support your head with your hands when rising from a lying position to avoid strain on the incision."
"Expose the scar to direct sunlight daily to help it fade."
12. Mme. Isabelle Gagnon, 42 years old, is 18 hours post-total thyroidectomy. She calls the nurse to her bedside and says, "I feel strange. My lips feel numb and vibrating, and my fingertips are tingling like they are asleep." The nurse assesses her and notes she is slightly anxious and her facial muscles twitch slightly when she speaks.
Medical Orders:
*Vital signs q4h.
*Monitor calcium levels.
*Notify MD of significant changes.
Question:
What do you suspect is happening to the patient?
*
She is hyperventilating due to anxiety.
She is developing hypocalcemia due to parathyroid gland injury.
She is having a reaction to the anesthesia.
She is experiencing a transient ischemic attack (TIA).
13. M. Claude Tremblay, 55 years old, is 2 hours post-thyroidectomy. He is resting in a semi-Fowler’s position. The nurse observes that M. Tremblay is making frequent swallowing movements, even though he is not drinking or eating. When asked, he reports a sensation of "pressure" in his neck but no severe pain. The visible dressing is dry.
Medical Orders:
*Monitor airway and bleeding.
*Ice pack to neck PRN.
Question:
What do you suspect is happening to the patient?
*
He has a sore throat from the endotracheal tube.
He is experiencing post-nasal drip.
He is bleeding internally.
He is having a nervous reaction to the surgery.