一位急性胰臟炎病人的血清鈣濃度為 7.2 mg/dL。護理師應預期出現哪種臨床表徵？
A client with acute pancreatitis presents with a serum calcium level of 7.2 mg/dL. Which clinical manifestation should the nurse anticipate?
- APositive Trousseau's sign✓ 正解Trousseau 氏徵呈陽性
- BIncreased bowel sounds腸鳴音增加
- CMuscle weakness and lethargy肌肉無力和倦怠
- DDeep tendon hyperreflexia深層腱反射亢進
血鈣低於 8.5 mg/dL 為低血鈣。胰臟炎時脂肪壞死會結合鈣離子導致低血鈣。低血鈣會增加神經肌肉興奮性，導致 Trousseau's 徵象（給予上臂血壓 cuff 加壓誘發手抽筋）與 Chvostek's 徵象。D 選項應為腱反射減弱（高血鈣）或增強（低血鈣常見，但選項 D 若指單純反射亢進可為一項，然而 A 為更特異性表徵）。
A serum calcium less than 8.5 mg/dL indicates hypocalcemia. In pancreatitis, fat necrosis binds calcium ions and produces hypocalcemia. Hypocalcemia increases neuromuscular excitability, producing Trousseau's sign (carpal spasm induced by inflation of a blood pressure cuff on the upper arm) and Chvostek's sign. Option D may refer to decreased deep tendon reflexes (in hypercalcemia) or enhanced reflexes (commonly seen in hypocalcemia); although hyperreflexia can occur with hypocalcemia, option A (Trousseau's sign) is a more specific manifestation.
台美臨床皆重視低血鈣的 Chvostek's 與 Trousseau's 評估，美國護理師常依實驗室報告主動完成這些床邊評估。