The nurses do not have consistent online access to clinical practice guidelines due to a poor connection to the Internet. The novice nurse is caring for a postoperative thyroidectomy client during the night shift

Question

The other nurses on the unit are inexperienced, and are unable to offer advice about how to care for this type of client. Which of the following could occur as a result? Select all that apply.
1. The nurse does not monitor the client for signs and symptoms of hypocalcemia.
2. The nurse ambulates the client three times during the first postoperative day.
3. The nurse carefully listens for bowel sounds in all four quadrants.
4. The nurse does not ensure that the incision site and the client's neck are maintained in a "straight" unbent position.
5. The client falls in the bathroom.

Answer 1

Answer: 1; 4

Rationale:
• The nurse does not monitor the client for signs and symptoms of hypocalcemia. Competent clinical practice is dependent upon up-to-date information. Nurses require consistent connection to the Internet to ensure that clinical practice guidelines are being followed. Currently, more hospitals are relying on online resources and less on printed books placed on the units. The nurse should have access to guidelines about how to care for this postoperative thyroidectomy client. The nurse should monitor the client for clinical manifestations of hypocalcemia due to manipulation of the parathyroid glands during thyroid surgery.
• The nurse ambulates the client three times during the first post-operative day. Competent clinical practice is dependent upon up-to-date information. Nurses require consistent connection to the Internet to ensure that clinical practice guidelines are being followed. Currently, more hospitals are relying on online resources and less on printed books placed on the units. The nurse should have access to guidelines about how to care for this postoperative thyroidectomy client. The nurse should ambulate the client three times during the first postoperative day and as the client can tolerate.
• The nurse carefully listens for bowel sounds in all four quadrants. Competent clinical practice is dependent upon up-to-date information. Nurses require consistent connection to the Internet to ensure that clinical practice guidelines are being followed. Currently, more hospitals are relying on online resources and less on printed books placed on the units. The nurse should have access to guidelines about how to care for this postoperative thyroidectomy client. The nurse should carefully assess bowel sounds for return of peristalsis.
• The nurse does not ensure that the incision site and the client's neck are maintained in a "straight" unbent position. Competent clinical practice is dependent upon up-to-date information. Nurses require consistent connection to the Internet to ensure that clinical practice guidelines are being followed. Currently, more hospitals are relying on online resources and less on printed books placed on the units. The nurse should have access to guidelines about how to care for this postoperative thyroidectomy client. The nurse should ensure that the incision site and neck remain in a straight and unbent position after surgery to eliminate pulling at the surgical site.
• The client falls in the bathroom. Competent clinical practice is dependent upon up-to-date information. Nurses require consistent connection to the Internet to ensure that clinical practice guidelines are being followed. Currently, more hospitals are relying on online resources and less on printed books placed on the units. The nurse should have access to guidelines about how to care for this postoperative thyroidectomy client. The client falling in the bathroom is less likely related to the specific surgery and more related to a lack of implementation of appropriate safety precautions.