To assess for hemorrhage after thyroidectomy, the nurse should:

• A. Assess upper chest for the patient positioned in high Fowler position.
• B. Turn the patient to the side to check; the patient must be kept flat in the bed.
• C. Lift up the neck dressing to assess for excessive bleeding.
• D. Examine behind patient's neck and upper back to assess for hemorrhage.

Answer: (D)

Hemorrhage after thyroidectomy is most dangerous when it forms a neck hematoma that can rapidly compromise the airway. The best way to detect this is to inspect the posterior neck and upper back, because blood and swelling from the incision can track to those areas and may be concealed by the front dressing. Checking behind the neck allows you to identify a developing hematoma early—before it causes airway obstruction—without disturbing the dressing or the wound site. While front dressings are important to monitor, hidden bleeding can accumulate posteriorly, so the nurse’s careful assessment of the back of the neck is essential. If you notice increasing swelling or signs of bleeding in that area, report immediately and be prepared for potential airway intervention.