一位病人在甲狀腺切除術後出現低血鈣症狀。護理師應進行哪些評估？（選所有適合的）
A client is experiencing symptoms of hypocalcemia following a thyroidectomy. Which assessments should the nurse perform? (Select all that apply.)
- ACheck for Trousseau's sign✓ 正解檢查 Trousseau 徵象
- BObserve for Chvostek's sign✓ 正解觀察 Chvostek 徵象
- CAssess for numbness and tingling in the fingers✓ 正解評估手指是否有麻木和刺痛感
- DMonitor for prolonged QT interval on the EKG✓ 正解監測心電圖上是否有 QT 間期延長
- EAssess for hyperactive deep tendon reflexes✓ 正解評估深腱反射是否亢進
甲狀腺切除術最常見的併發症之一是副甲狀腺受損或被誤切，導致副甲狀腺素（PTH）下降，進而引發低血鈣。低血鈣會增加神經肌肉的興奮性，導致一系列特異性體徵。Trousseau's sign（壓迫上臂誘發手足抽搐）和 Chvostek's sign（敲擊面神經引起臉部肌肉抽動）是診斷低血鈣的經典臨床測試。末梢感覺異常（如手指麻木感）通常是早期表現。心臟方面，低血鈣會導致心肌復極化延遲，呈現 QT 段延長，增加心律不整風險。此外，神經肌肉過度興奮也會表現為深腱反射亢進。這題涵蓋了低血鈣從感覺、運動到心臟電生理的全方位評估，護理師必須在術後密切觀察這些徵象，以預防喉部痙攣或抽搐發生。
One of the most common complications of thyroidectomy is damage to or inadvertent removal of the parathyroid glands, resulting in decreased parathyroid hormone (PTH) and consequent hypocalcemia. Hypocalcemia increases neuromuscular excitability, producing a series of characteristic signs. Trousseau's sign (carpopedal spasm elicited by compression of the upper arm) and Chvostek's sign (facial muscle twitching elicited by tapping over the facial nerve) are classic clinical tests for hypocalcemia. Peripheral paresthesias (such as tingling in the fingers) are often early manifestations. From a cardiac perspective, hypocalcemia delays myocardial repolarization, producing a prolonged QT interval and increasing the risk of arrhythmia. In addition, neuromuscular hyperexcitability may present as hyperactive deep tendon reflexes. This question covers a comprehensive sensory, motor, and cardiac electrophysiologic assessment of hypocalcemia, and the nurse must monitor closely after surgery to prevent laryngospasm or tetany.
在美國，這類評估被視為甲狀腺術後的標準護理（Nursing Protocol），護理師需自主執行並記錄。在台灣，除了基礎生命徵象外，醫師常會口頭叮囑注意『手腳麻』，護理師在執行 Trousseau's 或 Chvostek's 測試的頻率可能因醫院文化而異，但學理基礎完全相同。