Complication of total thyroidectomy include all except?

Chitranjjan National Cancer Institute Kolkata - 2021

Medical & Surgical Nursing

Medium

Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021

Explanation

Hypercalcemia, or high blood calcium, is not a complication of total thyroidectomy.
The primary calcium-related complication is the opposite condition: hypocalcemia (low blood calcium).
Hypocalcemia occurs due to potential damage or accidental removal of the parathyroid glands during thyroid surgery.
The parathyroid glands produce parathyroid hormone (PTH), which increases blood calcium levels. Without sufficient PTH, calcium levels fall.

Option A: Hoarseness is a known complication due to the risk of injury to the recurrent laryngeal nerve, which lies in close proximity to the thyroid gland and controls the vocal cords.
Option B: Airway obstruction is a potential life-threatening complication. It can be caused by a hematoma (collection of blood) compressing the trachea or by laryngeal edema (swelling).
Option C: Hemorrhage is a significant risk because the thyroid gland is highly vascular. Bleeding at the surgical site can lead to hematoma and airway compromise.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Postoperative complications of total thyroidectomy as background academic context rather than a clinical decision trigger.
A primary nursing responsibility after thyroidectomy is to maintain airway patency. A tracheostomy tray, suction equipment, and oxygen must be immediately available at the bedside.
Nurses must vigilantly monitor for signs of hypocalcemia, such as numbness, tingling around the lips and fingers, and muscle spasms. The presence of Chvostek's or Trousseau's sign should be reported immediately.
What if? If a patient had surgery to remove a parathyroid adenoma (a cause of hyperparathyroidism), then a potential complication would be persistent hypercalcemia if the removal was incomplete, or hypocalcemia if the remaining glands are suppressed or were also removed.

How to Approach the Question

First, identify the core subject of the question, which is 'complications of total thyroidectomy'.
Next, recognize the critical keyword 'except'. This signals that you must find the option that is NOT a complication.
Mentally review the anatomy of the neck around the thyroid gland. Consider the trachea (airway), recurrent laryngeal nerve (voice), major blood vessels (hemorrhage), and parathyroid glands (calcium regulation).
Evaluate each option against this anatomical knowledge: Injury to the nerve causes hoarseness. Bleeding causes hemorrhage. Swelling or bleeding can obstruct the airway.
Finally, analyze the calcium-related option. The parathyroid glands increase blood calcium. Removing them would cause a decrease (hypocalcemia), not an increase (hypercalcemia). Therefore, hypercalcemia is the correct exception.

Concept Tested & Keywords

Concept Tested: Postoperative complications of total thyroidectomy
Stem keywords: Complication, total thyroidectomy
Lead-in keywords: except
Negative lead-in flag: The question asks for the EXCEPTION, meaning the condition that is NOT a complication.

QuDXLvvBGXbAO1C5Xb56-g

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 27-29

E6 Medicine Davidson Principles Practice 24e p. 664-666