Marcus Pinel, 43-years-old, is brought back to the nursing unit following a thyroidectomy. Which of the following methods should the nurse use to assess for bleeding?
  1. Inspect the dressing for signs of hemorrhage
  2. Change the dressing applied in the operating room
  3. Check the latest hemoglobin to determine if there has been a drop in value
  4. Palpate the back of the neck and shoulders for evidence of bleeding
Explanation
Answer - D - Palpate the back of the neck and shoulders for evidence of bleeding. The danger of hemorrhage is greatest during the first 24 hours following thyroid surgery. The tendency is for blood to flow down at the sides and posteriorly if hemorrhage occurs in the area of the neck. Inspecting the dressings for signs of hemorrhage may not reveal bleeding (Choice A). Changing dressings immediately after surgery is not appropriate (Choice B). A drop in hemoglobin may be a clue to bleeding, but is not the best initial assessment action (Choice C).
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