— 生理適應 · HARD · MCQ —
病人術後 24 小時出現手足抽搐與嘴唇周圍麻木。護理師應預期哪項檢驗結果異常？
A client is 24 hours post-thyroidectomy. The nurse notes carpopedal spasms and tingling around the mouth. Which laboratory result should the nurse anticipate?
- ADecreased serum phosphorus血清磷降低
- BDecreased serum calcium✓ 正解血清鈣降低
- CIncreased serum magnesium血清鎂升高
- DIncreased serum potassium血清鉀升高
— Explanation · 中文詳解 —
甲狀腺切除術可能誤傷副甲狀腺，導致副甲狀腺素（PTH）分泌不足。PTH 下降會導致低血鈣，進而引發神經肌肉興奮性增高，表現為 Chvostek 徵象或 Trousseau 徵象（手足抽搐）。此為術後緊急併發症。
Thyroidectomy may inadvertently injure the parathyroid glands, leading to deficient parathyroid hormone (PTH) secretion. Decreased PTH causes hypocalcemia, producing neuromuscular hyperexcitability that manifests as Chvostek's sign or Trousseau's sign (carpopedal spasm). This is a postoperative emergency complication.
✦ 台美臨床差異
兩地均高度重視術後血鈣監測，但美國護理師對於 Chvostek 徵象的評估訓練更為普遍。