Which intervention is most important in the plan of care for a client who is 12 hours post-thyroidectomy?

• A. Maintain semi-Fowler's position.
• B. Administer a high-volume intravenous fluid bolus.
• C. Place the client in a supine flat position.
• D. Encourage ambulation immediately.

Answer: (A)

After thyroidectomy, protecting the airway takes priority because swelling or a hematoma at the neck can quickly obstruct breathing. Elevating the head and upper body to a semi-Fowler's position (head of bed about 30–45 degrees) uses gravity to reduce neck edema, keeps the airway more open, and makes it easier to observe for signs of airway compromise or bleeding. This position also supports better ventilation and comfortable incision healing.

Keeping the client flat would increase neck swelling and the risk of airway obstruction, and asking them to ambulate immediately could strain the surgical site and trigger bleeding. A large IV fluid bolus isn’t the immediate priority for airway safety after thyroidectomy and could lead to fluid overload if not needed. So, maintaining a semi-Fowler's position best supports airway safety and recovery in the first postoperative hours.