Final answer:
The priority nursing action for a patient post-total laryngectomy and radical neck dissection is to monitor for bleeding, as it poses a significant risk in the early postoperative period.
Step-by-step explanation:
When the nurse is caring for a patient who has had a total laryngectomy and radical neck dissection during the first 24 hours after surgery, the priority nursing action is to monitor for bleeding. This is crucial because the patient has undergone a significant surgical procedure involving the throat, which can have a high risk for postoperative bleeding due to the vascular nature of the surgical site. The nursing staff is essential in the immediate postoperative period to ensure prompt identification and management of any bleeding, which may compromise the patient's airway or lead to other complications.
Assessment of breath sounds is also critical to ensure that the airway remains unobstructed and the patient is adequately oxygenating. However, the immediate risk of hemorrhage takes precedence. Cleaning the inner cannula and avoiding changing the tracheostomy ties are also important, but these do not take precedence over the monitoring for bleeding and maintaining a patent airway.