Hoarseness vs hypocalcemia? Which will kill you first?

[LM NY]

I am debating with someone about a serious complication after thyroidectomy. Both hoorificeness and hypocalcemia can occur, but isn't hoorificeness something a nurse should be MORE concerned about?? I am guessing edema in the throat(hoorificeness) can lead to constriction of the airway. According to Maslow, wouldn't that hoorificeness be more of a concern than hypocalcemia? I would appreciate some input. Thanks!

[mrsboots87]

Hoorificeness kills no one. Hoorificeness is merely a s/s of something else. That something else can be something as insignificant as a sore throat from a cold to the throat closing up from all kinds of things. You cannot say that someone with hoorificeness is in a more serious condition then someone with hypocalcemia without further assessment. Hoorificeness plus stridor and audible wheezing, maybe some cyanosis, and so on then sure. But by itself, no. You are wrong. Hypocalcemia would be a confirmed issue that will definitely cause problems up to and including death from symptoms. If told I could only treat one thing for an NCLEX question, I would go with hypocalcemia because it is confirmed. In real life, I would assess further before deciding which is a priority finding.

[blackribbon]

An NCLEX question would present you with symptoms which in this case would be a post surgical thyroidectomy patient with hoorificeness and is complaining of tingling around their mouth or in their fingertips (it wouldn't tell you hypocalcemia)...and you have to do your priority assessments in order. In which case, assessing respiratory status would be the priority, then assessing the labs (In the real world, this may mean getting a doctor's order to draw STAT labs since this wouldn't have existed prior to surgery and wouldn't already be part of the patient's file yet).

[littlepeopleRNICU]

If the hoorificeness is due to airway obstruction that's serious enough, you'd need to rely on further assessment skills. Given the two options and no other information, I would pick hypocalcemia.

[mrsboots87]

Also keep in mind that NCLEX world is perfect world. The questions will give you everything you need to know to answer. If you have to add to the answer to make it right then it is probably wrong. My instructors would explain it that if a question is about post thyroidectomy and list 4 things and asks which is a priority then between those two hyposcalcenia would be correct because it is confirmed. There would have to be a lab result to call someone hypocalcemic in NCLEX world. For hoorificeness to be a priority then you would need to further assess and find other symptoms. Since no other symptoms are given, then hoorificeness should be assumed to be a stand alone symptom.