Page 1397 - Saunders Comprehensive Review For NCLEX-RN

exercise program and avoiding
prolonged inactivity.
C. Parathyroidectomy
1. Description: Removal of 1 or more of the parathyroid
glands
a. Endoscopic radioguided
parathyroidectomy with
autotransplantation is a common
procedure.
b. Parathyroid tissue is transplanted in the
forearm or near the
sternocleidomastoid muscle, allowing
PTH secretion to continue.
2. Preoperative interventions
a. Monitor electrolytes, calcium,
phosphate, and magnesium levels.
b. Ensure that calcium levels are
decreased to near-normal values.
c. Inform the client that talking may be
painful for the first day or two after
surgery.

3. Postoperative interventions

a. Monitor for respiratory distress.
b. Place a tracheotomy set, oxygen, and
suctioning equipment at the bedside.
c. Monitor vital signs.
d. Position the client in semi-Fowler’s
position.
e. Assess neck dressing for bleeding.
f. Monitor for hypocalcemic crisis, as
evidenced by tingling and twitching in
the extremities and face.
g. Assess for positive Trousseau’s sign or
Chvostek’s sign, which indicates
tetany.
h. Monitor for changes in voice pattern
and hoarseness.
i. Monitor for laryngeal nerve damage.
j. Instruct the client in the administration
of calcium and vitamin D supplements
as prescribed.
VII. Problems of the Pancreas
A. Diabetes mellitus

1. Description

a. Chronic disorder of impaired

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