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Nursing QUESTION #9291
Question 1
A patient undergoing total thyroidectomy returns from the OT. Four hours post-operatively, the nurse observes stridor and the patient is having difficulty swallowing. The most likely cause is:
  • Hypocalcemia causing laryngospasm
  • Wound hematoma causing tracheal compression✔️
  • Recurrent laryngeal nerve damage
  • Thyroid storm
Correct Answer Explanation

Post-thyroidectomy stridor with difficulty swallowing within hours of surgery most likely indicates wound hematoma compressing the trachea — a surgical emergency.

Post-thyroidectomy complications to differentiate:

ComplicationTimingSigns
Wound hematomaFirst few hoursStridor, tracheal deviation, neck swelling, cyanosis
Hypocalcemia (tetany)24–72 hrs post-opTingling, Chvostek's, Trousseau's, muscle cramps
RLN damageImmediate post-opHoarseness, voice change (not stridor)
Thyroid stormDuring or shortly after surgeryFever, tachycardia, agitation, hypertension

Nursing action for hematoma: Call surgeon STAT, prepare for emergency wound opening at bedside (suture removal kit should be at bedside).