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Question

Difficulty: MediumReduction of Risk Potential

During the immediate postoperative period following a subtotal thyroidectomy, a client reports a sudden sensation of tightness in the anterior neck region and exhibits frequent, forced swallowing. The respiratory rate is currently 26 breaths/minute with faint inspiratory stridor. To mitigate the highest immediate risk to the client, which action must the nurse execute first?

  1. Alert the rapid response team and prepare the emergency tracheostomy equipment at the bedside.Answer
  2. B
    Obtain a sample for arterial blood gas analysis to determine the exact degree of hypoxemia.
  3. C
    Position the client flat on their back with the neck slightly hyperextended.
  4. D
    Provide the PRN scheduled analgesic to relieve the sensation of throat pressure.

Answer

The nurse must immediately alert the rapid response team and prepare emergency tracheostomy equipment to secure the airway.
The client is exhibiting classic signs of an expanding hematoma and airway compression (frequent swallowing, neck tightness, stridor, and tachypnea). This is a surgical emergency. The immediate priority is to alert the rapid response team and prepare for advanced airway management before complete airway occlusion occurs.

Step-by-Step Solution

1
Analyze the clinical presentation.
The client has neck tightness, frequent swallowing, tachypnea, and inspiratory stridor.
These are classic signs of an expanding hematoma or hemorrhage in the neck following a thyroidectomy.
2
Evaluate the physiological impact.
The hematoma is physically compressing the trachea, leading to a compromised airway.
Airway patency is the highest priority in the ABC (Airway, Breathing, Circulation) framework.
3
Determine the priority intervention.
Immediate medical intervention is required to secure the airway before complete occlusion occurs.
Nursing interventions like repositioning or diagnostics are insufficient and will critically delay life-saving airway management.

Key Concept

Post-thyroidectomy airway obstruction secondary to hematoma formation requires immediate emergency intervention.
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Topics

Reduction of Risk Potential

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