Postoperative thyroidectomy: if the patient suddenly becomes short of breath and develops stridor, what action should the nurse implement first?

• A. Call the emergency response team
• B. Administer inhaled bronchodilator
• C. Reassure patient and continue monitoring
• D. Obtain arterial blood gas

Answer: (A)

The key concept is recognizing acute airway obstruction after neck surgery and acting to secure the airway immediately. A sudden onset of shortness of breath with stridor after thyroidectomy strongly suggests upper airway narrowing, often from a postoperative hematoma or edema compressing the trachea. The first action is to activate the emergency response team so skilled personnel and equipment for urgent airway management can be mobilized right away. This prioritizes securing the airway, which is the most immediate threat to life in this scenario.

While awaiting help, you can support the patient with oxygen if available and keep them as comfortable as possible, but anything that delays airway management—like waiting for tests or giving medications aimed at different problems—could be dangerous. An inhaled bronchodilator targets bronchospasm, not an upper airway obstruction. Reassurance and passive monitoring won’t address the obstruction, and obtaining an arterial blood gas would not save the airway in that moment.