The nurse caring for a patient who has had a subtotal thyroidectomy reviews the plan of care and determines which problem is the priority for this client in the immediate postoperative period?

The nurse caring for a patient who has had a subtotal thyroidectomy reviews the plan of care and determines which problem is the priority for this client in the immediate postoperative period?

• A. Infection
• B. Bleeding
• C. Dehydration
• D. Urinary retention

Answer: (B)

After a subtotal thyroidectomy, the most urgent risk is bleeding into the neck that can rapidly compress the airway. A hematoma at the surgical site can threaten breathing within hours, so stopping bleeding and preserving the airway takes priority. The nurse should closely monitor the dressing and the neck for increasing drainage or swelling and assess the patient’s airway and breathing (rate, effort, any stridor or distress). Vital signs are watched closely for signs of shock, such as tachycardia or falling blood pressure. Be prepared to act immediately if bleeding or airway compromise is suspected, with ready access to suction and emergency airway equipment and prompt communication with the surgical team. While infection, dehydration, and urinary retention are concerns, they are not as immediately dangerous in the immediate postoperative period as a bleeding hematoma threatening the airway.

After a subtotal thyroidectomy, the most urgent risk is bleeding into the neck that can rapidly compress the airway. A hematoma at the surgical site can threaten breathing within hours, so stopping bleeding and preserving the airway takes priority. The nurse should closely monitor the dressing and the neck for increasing drainage or swelling and assess the patient’s airway and breathing (rate, effort, any stridor or distress). Vital signs are watched closely for signs of shock, such as tachycardia or falling blood pressure. Be prepared to act immediately if bleeding or airway compromise is suspected, with ready access to suction and emergency airway equipment and prompt communication with the surgical team. While infection, dehydration, and urinary retention are concerns, they are not as immediately dangerous in the immediate postoperative period as a bleeding hematoma threatening the airway.