Page 1394 - Saunders Comprehensive Review For NCLEX-RN

b. Assess electrolyte levels.
c. Assess for hyperglycemia.

d. Instruct the client in how to

perform coughing and deep-breathing
exercises and how to support the neck
in the postoperative period when
coughing and moving.
e. Administer antithyroid medications,
iodides, propranolol, and
glucocorticoids as prescribed to
prevent the occurrence of thyroid
storm.
3. Postoperative interventions

a. Monitor for respiratory distress.
b. Have a tracheotomy set, oxygen, and
suction at the bedside.
c. Limit client talking, and assess level of
hoarseness.
d. Avoid neck flexion and stress on the
suture line.
e. Monitor for laryngeal nerve damage, as
evidenced by airway obstruction,
dysphonia, high-pitched voice, stridor,
dysphagia, and restlessness.
f. Monitor for signs of hypocalcemia and
tetany, which can be caused by trauma
to the parathyroid gland (Box 46-12).
g. Prepare to administer calcium
gluconate as prescribed for tetany.
h. Monitor for thyroid storm.

Following thyroidectomy, maintain the

client in a semi-Fowler’s position. Monitor the
surgical site for edema and for signs of bleeding and
check the dressing anteriorly and at the back of the
neck. Monitor for inflammation, which may block the
airway. An emergency tracheostomy kit should be at
the bedside.
VI. Parathyroid Gland Problems
A. Hypoparathyroidism
1. Description
a. Condition caused by hyposecretion of
parathyroid hormone by the
parathyroid gland
b. Can occur following thyroidectomy

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