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Difficulty: MediumBasic Care and Comfort

Following a subtotal thyroidectomy, a client is admitted to the medical-surgical floor for postoperative recovery. The practical nurse is implementing non-pharmacological interventions for this client. Which specific actions should be included? Select all that apply.

  1. Support the client's head and neck with a pillow when assisting with position changesAnswer
  2. B
    Keep the client in a flat, supine position while resting to maintain cervical alignment
  3. Apply a prescribed ice collar to the anterior neck areaAnswer
  4. D
    Instruct the client to perform active neck extension exercises hourly to reduce muscle spasms
  5. Offer small sips of cool water and gentle oral hygiene once the gag reflex is confirmedAnswer
  6. F
    Assign the unlicensed assistive personnel (UAP) to perform the initial evaluation of the client's swallowing ability

Answer

The correct interventions are supporting the head and neck during movement, applying an ice collar, and providing cool fluids with oral hygiene after verifying the gag reflex.
Following a thyroidectomy, basic care focuses on minimizing tension on the surgical incision and reducing swelling. Supporting the head and neck prevents strain on the sutures during movement. Applying an ice collar provides localized analgesia and decreases edema that could otherwise threaten the airway. Providing oral care and cool liquids promotes mucosal hydration and comfort without causing the thermal vasodilation that warm liquids might provoke.

Step-by-Step Solution

1
Analyze the specific physiological risks associated with a thyroidectomy.
The primary concerns are airway compromise from edema and tension on the cervical suture line.
Understanding surgical risks dictates the necessary comfort and safety measures.
2
Evaluate positioning and mobility interventions against these risks.
The head and neck must be supported during repositioning to prevent strain. A flat position or neck extension is contraindicated.
Proper alignment without tension prevents dehiscence and promotes venous drainage.
3
Select appropriate localized comfort measures.
An ice collar is indicated to reduce swelling and provide pain relief.
Cold therapy is standard basic care for localized postoperative inflammation.
4
Determine safe nutritional and hygiene practices.
Providing oral care and cool liquids is safe only after the nurse confirms an intact gag reflex.
Basic care must prioritize aspiration prevention while ensuring hydration.

Key Concept

Postoperative Basic Care and Comfort
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Topics

Basic Care and Comfort

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