NCLEX-PN® ExaminationReduction of Risk PotentialHard
An LPN is assisting with the care of a client who underwent a thyroidectomy 12 hours ago. Which finding would be the MOST concerning and require immediate intervention?
- AHeart rate of 98 beats/min and blood pressure of 130/85 mmHg.
- BClient reports mild throat pain when swallowing.
- CClient exhibits frequent muscle twitching and tingling around the mouth.
- DIncisional dressing has a small amount of serosanguineous drainage.
Show answer & explanationAnswer & explanation
Correct answer: C. Client exhibits frequent muscle twitching and tingling around the mouth.
Muscle twitching and perioral tingling are classic signs of hypocalcemia, which can occur after a thyroidectomy due to accidental removal or damage to the parathyroid glands. Severe hypocalcemia can lead to tetany, laryngospasm, and seizures, making it an emergency.
Why the other options are wrong
- A. These vital signs are slightly elevated but not immediately life-threatening in the absence of other severe symptoms.
- B. Mild throat pain is an expected finding after throat surgery.
- D. A small amount of serosanguineous drainage is common post-op; excessive bleeding would be concerning.
Post-Thyroidectomy Complications
Potential adverse effects following thyroid gland removal, including hemorrhage, airway obstruction, and hypocalcemia.
- Hypocalcemia is a risk due to parathyroid gland injury/removal.
- Signs of hypocalcemia include tetany, tingling, muscle spasms.
- Hemorrhage and airway compromise are also critical concerns.
Memory trick: THYROID: Tingling, Hemorrhage, Airway, Voice, Infection, Recurrent laryngeal nerve Damage.