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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:
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:
| Complication | Timing | Signs |
|---|---|---|
| Wound hematoma | First few hours | Stridor, tracheal deviation, neck swelling, cyanosis |
| Hypocalcemia (tetany) | 24–72 hrs post-op | Tingling, Chvostek's, Trousseau's, muscle cramps |
| RLN damage | Immediate post-op | Hoarseness, voice change (not stridor) |
| Thyroid storm | During or shortly after surgery | Fever, tachycardia, agitation, hypertension |
Nursing action for hematoma: Call surgeon STAT, prepare for emergency wound opening at bedside (suture removal kit should be at bedside).
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