Several weeks before scheduled thyroid surgery, a client is prescribed methimazole. The nurse should instruct the client to perform which daily self-assessment?

• A. Fluid intake and output
• B. Body temperature and pulse rate
• C. Respiratory effort and oxygen saturation
• D. Skin turgor and mucous membranes

Answer: (A)

When a patient with hyperthyroidism is prepared for thyroidectomy, the goal is to bring thyroid hormone levels toward a stable, euthyroid state and to ensure the patient remains hydrated and hemodynamically stable for anesthesia. Tracking daily fluid balance—how much fluid is taken in and how much urine is produced—helps the nurse and patient detect early dehydration or fluid overload. Dehydration can complicate anesthesia induction and hemodynamic stability, while maintaining adequate volume supports organ perfusion during surgery. This simple self-assessment provides practical, actionable information that supports safer perioperative planning.

Vital signs (temperature and pulse) are important for catching signs of over- or under-treatment of thyroid hormone, but they don’t directly reflect volume status. Respiratory effort and oxygen saturation are critical if airway or pulmonary issues arise, especially with goiter or edema, but they’re less informative for routine hydration status. Skin turgor and mucous membranes can indicate hydration but are less reliable and practical for daily self-monitoring over weeks. Tracking fluid intake and output offers the most straightforward indicator of hydration and fluid balance in this preoperative context.