Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?
A. Tetany
B. Hemorrhage
C. Thyroid storm
D. Laryngeal nerve damage
Correct Answer: A. Tetany
Tetany may result if the parathyroid glands are excised or damaged during thyroid surgery. Hypoparathyroidism results in hypocalcemia which may become symptomatic and life-threatening. Criteria for hyperparathyroidism have not been clearly established, but the reported incidence is approximately 1/3 with the majority of these being temporary. It is important to maintain a consistent protocol for calcium management after total or completion thyroidectomy to minimize related complications.
Option B: Hemorrhage is a potential complication after thyroid surgery but is characterized by tachycardia, hypotension, frequent swallowing, feelings of fullness at the incision site, choking, and bleeding. Hemorrhage causing airway compression may be life-threatening.
Option C: Thyroid storm is another term for severe hyperthyroidism — not a complication of thyroidectomy. Thyroid storm, also known as thyrotoxic crisis, is an acute, life-threatening complication of hyperthyroidism. It is an exaggerated presentation of thyrotoxicosis. It comes with sudden multisystem involvement.
Option D: Laryngeal nerve damage may occur postoperatively, but its signs include a hoarse voice and, possibly, acute airway obstruction. Injury to the recurrent laryngeal nerve results in voice change and possibly change in the swallow. This is more commonly temporary but may be permanent in less than 1% of cases.
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