A nurse is caring for a client who returns from a thyroidectomy. The client suddenly develops stridor, neck swelling, and reports difficulty swallowing. Which action should the nurse take first?
- A.Administer prescribed oral calcium supplements immediately
- B.Notify the surgeon and prepare for emergency airway management
- C.Elevate the head of the bed to 90 degrees and apply oxygen by face mask
- D.Obtain a stat serum calcium level and 12-lead ECG
Show answer & rationale
Correct answer
B. Notify the surgeon and prepare for emergency airway management
Rationale
B is correct: Stridor plus neck swelling after thyroidectomy signals tracheal compression from a hematoma or laryngeal edema, an immediately life-threatening airway emergency. The surgeon must be notified right away and the team prepared for intubation or surgical decompression. A is incorrect: Oral calcium addresses hypocalcemia (a common post-thyroidectomy complication) but hypocalcemia causes tetany or perioral tingling, not stridor. Giving calcium will not relieve an obstructed airway. C is incorrect: Elevating the HOB and applying supplemental oxygen are supportive, but they do not address the mechanical obstruction and should not delay surgical notification. D is incorrect: Lab work is appropriate for suspected hypocalcemia but is a lower priority than securing the airway in a patient showing signs of acute obstruction.
Key concepts