甲狀腺切除術後 4 小時的病人，下列哪項評估結果最令人擔憂，需立即通知外科醫師？
A nurse is assessing a client 4 hours after a thyroidectomy. Which finding is the most concerning and requires immediate notification of the surgeon?
- AMild soreness at the incision site切口處輕微疼痛
- BIncision site dressing is dry and intact切口處敷料乾燥且完整
- CFrequent swallowing and neck fullness✓ 正解頻繁吞嚥及頸部飽脹感
- DHoarseness when speaking說話時聲音嘶啞
甲狀腺切除術後，頸部周圍出現頻繁吞嚥動作及頸部腫脹，極可能是術後出血並壓迫氣管的早期徵兆。由於手術區域接近頸部大血管，術後血腫可能會在短時間內壓迫氣道，導致呼吸窘迫甚至危及生命。必須優先排除此致命風險，而非僅關注輕微聲帶受損或傷口疼痛。
After a thyroidectomy, frequent swallowing and neck fullness are highly suggestive of postoperative bleeding compressing the trachea. Because the surgical area lies near the great vessels of the neck, a postoperative hematoma can compress the airway within a short time, causing respiratory distress or even death. This life-threatening risk must be ruled out first, rather than focusing only on mild vocal cord injury or wound pain.
美國護理師對術後急症的判斷與啟動 RRT（快速反應小組）機制非常嚴謹；台灣則多先行評估傷口後再通知主治醫師。