During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement?
A. “The head of your bed must remain flat for 24 hours after surgery.”
B. “You should avoid deep breathing and coughing after surgery.”
C. “You won’t be able to swallow for the first day or two.”
D. “You must avoid hyperextending your neck after surgery.”
Correct Answer: D. “You must avoid hyperextending your neck after surgery.”
To prevent undue pressure on the surgical incision after subtotal thyroidectomy, the nurse should advise the client to avoid hyperextending the neck. Caution patient to avoid bending neck; support head with pillows. Reduces the likelihood of tension on the surgical wound.
Option A: The client may elevate the head of the bed as desired. Keep side rails raised and padded, bed in a low position, and airway at the bedside. Avoid the use of restraints. Reduces the potential for injury if seizures occur.
Option B: The client should perform deep breathing and coughing to help prevent pneumonia. Assist with repositioning, deep breathing exercises, and/or coughing as indicated. Maintains clear airway and ventilation. Although “routine” coughing is not encouraged and may be painful, it may be needed to clear secretions.
Option C: Investigate reports of difficulty swallowing, drooling of oral secretions. May indicate edema or sequestered bleeding in tissues surrounding the operative site. Check dressing frequently, especially the posterior portion. If bleeding occurs, the anterior dressing may appear dry because blood pools dependently.
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