Davidson is 8 hours post partial thyroidectomy for Grave's disease. What is the best documentation by the nurse of evaluation outcome criteria for the nursing diagnosis risk for effective airway clearance?
A)Dressing is clean dry and intact, pain minimal and controlled, alert, and oriented
B)Vital signs stable; client supports neck with hand during change of position
C)No tracheal stridor, speaks clearly, and denies numbness or tingling
D)Balanced intake and output, vital signs stable, and alert and oriented

Question

Quizplus · Accepted Answer

Early signs of edema of the larynx leading to airway obstruction are tight-fitting dressing, stridor, stertor, and/or weak or harsh voice. Numbness or tingling of the extremities, lips, or mouth are signs of hypocalcemia that can lead to respiratory distress due to tetany. The data in the other choices are important routine postoperative assessments, but they do not relate to the client's airway.

Davidson Is 8 Hours Post Partial Thyroidectomy for Grave's Disease