護理師照顧一名甲狀腺切除術後 2 小時的病患。病患主訴手指及嘴唇周圍有刺痛感。護理師接下來應採取哪項行動？
The nurse is caring for a client who is 2 hours post-operative following a thyroidectomy. The client reports tingling in the fingers and around the mouth. Which action should the nurse take next?
- AAssess for Trousseau's or Chvostek's sign✓ 正解評估是否有 Trousseau 徵象或 Chvostek 徵象
- BCheck the client's surgical dressing for bleeding檢查病人的手術敷料是否有出血
- CAdminister the prescribed PRN pain medication給予處方 PRN 止痛藥物
- DEncourage the client to use the incentive spirometer鼓勵病人使用誘發性肺量計
甲狀腺切除術後最嚴重的併發症之一是副甲狀腺受損或誤除，導致急性低血鈣。手指和口周刺痛（Paresthesia）是低血鈣的早期典型徵兆。護理師應立即評估 Trousseau's sign（壓脈帶誘發手部抽搐）或 Chvostek's sign（敲擊顏面神經引起抽動）來確認神經肌肉興奮性是否增加。若確認為陽性，則需預備補充葡萄糖酸鈣（Calcium gluconate）。選項 B 雖然重要，但與刺痛症狀無直接關聯；選項 D 與 C 均無法解決潛在的電解質危急狀況。
One of the most serious complications after thyroidectomy is damage to or inadvertent removal of the parathyroid glands, leading to acute hypocalcemia. Paresthesia of the fingers and around the mouth is an early classic sign of hypocalcemia. The nurse should immediately assess for Trousseau's sign (carpopedal spasm induced by a blood pressure cuff) or Chvostek's sign (twitching elicited by tapping the facial nerve) to confirm whether neuromuscular excitability is increased. If confirmed positive, calcium gluconate should be prepared for administration. Option B is important but unrelated to paresthesia symptoms; options D and C fail to address the underlying electrolyte emergency.
美國 NCLEX 非常強調甲狀腺術後的血鈣監測，常考 Calcium Gluconate 需備於床邊；台灣臨床護理師同樣監測此徵象，但在術後初期通常會更頻繁地抽血追蹤電解質，而不僅依賴理學檢查。