Homework/ Case Study Help!

[cyncopia]

Hi Everyone, Here is the question

Sarah Klaus had a thyroidectomy to treat hyperthyroidism. The physician ordered a tracheotomy tray to be kept at the bedside. Why is Sarah at risk for respiratory complications following a thyroidectomy? Answer this question in terms of electrolyte imbalances.

I understand why she may be at risk for respiratory complications such as damage to nerves, spasms, shock...but when I brink in electrolytes and respiratory acidosis?? or alkalosis?? I think acidosis I start getting to confused. I just need to be directed in a direction to think in simpler terms before I start getting all confused with these concepts. :banghead:Thanks!!

[Daytonite, BSN, RN]

Complications of a thyroidectomy include the following:

• hemorrhage
  
• parathyroid damage
  
• hypocalcemia (because a parathyroid gland was accidentally nicked out)
  
• tetany (because a parathyroid gland was accidentally nicked out)
  
• laryngeal nerve damage
  
• vocal cord paralysis
  
• thyroid storm
  

Respiratory complications can occur because of swelling in the surgical area that will obstruct the respiratory passage. Anytime there is cutting into and disruption of the tissues the inflammatory and healing responses begin. Inflammatory response includes redness, heat, swelling, and pain, enough sometimes that in the area of the neck the windpipe can become obstructed and respiratory distress can occur. It would like being strangulated if the swelling was significant enough. O2 has difficulty getting in and CO2 has difficulty getting out. CO2 begins to build up in the system and the person becomes hypoxic. As blood CO2 rises and blood O2 lowers the patient exhibits symptoms of stridor, muffled voice, respiratory distress, eventually hypoxia, and finally mental status changes.