Which preoperative instruction is appropriate for a patient scheduled for thyroidectomy?

• A. Cough and deep breathe every hour.
• B. Support the head with the hands when changing position.
• C. Perform range-of-motion exercises of the head and neck.
• D. Apply gentle pressure against the incision when swallowing.

Answer: (B)

Protecting the neck and incision area to prevent stress on the suture line is the key idea here. After thyroid surgery, the neck is vulnerable, and even small movements can pull on the incision and disrupt healing or cause bleeding. Having the patient support the head with the hands when changing position keeps the neck in a neutral, stable position and reduces traction on the incision, which helps prevent complications and promotes proper healing.

Coughing and deep breathing are important for preventing pneumonia, but after thyroidectomy, activities that strain the neck should be approached with caution and typically with neck support; the focus preoperatively is on minimizing neck movement rather than forcing frequent coughing. Range-of-motion exercises of the head and neck would place strain on the fresh incision and are not appropriate preoperatively. Pressing gently on the incision when swallowing could also disrupt the healing incision. The simple, protective habit of using the hands to support the head during position changes best preserves the stability of the surgical site.