# A nurse is assessing a client 4 hours after a total thyroidectomy. The client suddenly reports difficulty swallowing and a feeling of tightness in the neck. The nurse notes swelling at the incision site and hears a high-pitched sound when the client breathes. What should the nurse do first?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=505809&lang=en  
> language: en  
> subject: Reduction of Risk Potential  
> category: ROR

## Question

A nurse is assessing a client 4 hours after a total thyroidectomy. The client suddenly reports difficulty swallowing and a feeling of tightness in the neck. The nurse notes swelling at the incision site and hears a high-pitched sound when the client breathes. What should the nurse do first?

## Option

1. Apply a cold pack to the neck to reduce swelling.
2. Administer the prescribed analgesic for discomfort.
3. Place the client in a supine position and elevate the legs.
4. Call for help and prepare for emergency airway management. **✔ Correct answer**

**Correct answer: 4**

## Explanation

After thyroidectomy, sudden neck swelling, dysphagia, and stridor suggest an expanding neck hematoma that can rapidly compress the airway. The priority is to call for immediate help and prepare for emergency airway management, as this is a life-threatening situation. Applying a cold pack may not sufficiently reduce a hematoma and delays definitive care. Administering an analgesic does not address the airway threat. Placing the client supine with legs elevated is inappropriate and could worsen respiratory distress.

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