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Which action will the nurse take for the postoperative care of the patient who had a thyroidectomy?
- A. Assessing ability to speak by asking him or her to recite name and address every hour
- B. Maintaining anatomic position of the head when moving a patient
- C. Assisting a patient to hyperextend the head to assess for muscle damage
- D. Doing voice check every 2 hours
- E. Turning, coughing every hour
- F. Checking for bleeding at the sides and the back of the head
Correct Answer: B,D,F
Rationale: The nurse should hold the head in an anatomic position when moving the patient to prevent tension on the suture line, do a voice check every 2 to 4 hours by asking the patient to say 'ah'; the patient is not turned nor is coughing recommended immediately after a thyroidectomy.
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Another term for hyperglycemic reaction is diabetic ___
Correct Answer: ketoacidosis
Rationale: Hyperglycemic reaction-the body eliminates the excess glucose by the kidneys releasing it in the urine. Diabetic ketoacidosis (DKA) (acidosis accompanied by an accumulation of ketones in the blood), formerly called diabetic coma, may develop and the patient could die. DKA is a severe metabolic disturbance caused by an acute insulin deficiency, decreased peripheral glucose use, and increased fat mobilization and ketogenesis.
Which instructions will the nurse provide to a patient with diabetes to prevent injury to the feet?
- A. Soak feet in warm water every day.
- B. Avoid going barefoot and always wear shoes with soles.
- C. Use of commercial keratolytic agents to remove corns and calluses are preferred to cutting off corns and calluses.
- D. Use a heating pad to warm feet when they feel cool to the touch.
Correct Answer: B
Rationale: Sturdy, properly fitting shoes should be worn. Use of corn removers and heating pads is not beneficial to preserve the health of a diabetic's feet.
Which instructions will the nurse reinforce in the discharge instructions for a 47-year-old patient with hypothyroidism?
- A. Taking medication whenever symptoms cause discomfort
- B. Decreasing fluid and fiber intake
- C. Consuming foods rich in iron
- D. Seeing the health care provider regularly for follow-up care
Correct Answer: D
Rationale: Regular checkups are essential, because drug dosage may have to be adjusted from time to time.
Which extra equipment will the nurse provide at the bedside of a patient who has returned to the nursing unit after a thyroidectomy three hours ago?
- A. Large bandage scissors
- B. Tracheotomy tray
- C. Ventilator
- D. Water-sealed drainage system
Correct Answer: B
Rationale: There should be a suction apparatus and tracheotomy tray available for emergency use.
To which diet should a patient with Cushing syndrome adhere?
- A. Less sodium
- B. More calories
- C. Less potassium
- D. More carbohydrates
Correct Answer: A
Rationale: The diet should be lower in sodium to help decrease edema.