病人術後接受次全甲狀腺切除術。術後 24 小時內應優先進行哪些評估？（選所有適合的）
A client is recovering from a subtotal thyroidectomy. Which assessments are priority to perform during the first 24 hours? (Select all that apply.)
- ACheck for neck swelling✓ 正解檢查是否有頸部腫脹
- BMonitor for laryngeal nerve damage✓ 正解監測喉返神經損傷
- CAssess for tetany✓ 正解評估是否有手足搐搦
- DMaintain high-Fowler's position維持高半坐臥位
- EMonitor for respiratory distress✓ 正解監測是否有呼吸窘迫
次全甲狀腺切除術（subtotal thyroidectomy）後，病人面臨多種潛在的術後併發症，尤其在術後初期（24 小時內）需嚴密監測。首先，手術部位的出血和腫脹可能壓迫氣管，導致呼吸道阻塞（respiratory distress），因此監測頸部腫脹（neck swelling）與呼吸狀況至關重要。其次，手術可能損傷喉返神經（recurrent laryngeal nerve），引起聲帶麻痺，影響聲音與呼吸，故需監測神經損傷跡象。再者，甲狀腺手術常伴隨副甲狀腺（parathyroid glands）的意外移除或損傷，副甲狀腺負責調節鈣離子，其功能受損會導致低血鈣（hypocalcemia），進而引發手足抽搐（tetany）。因此，術後 24 小時內，應優先評估氣道安全、神經功能及鈣離子平衡。
After a subtotal thyroidectomy, the client is at risk for several postoperative complications, especially during the first 24 hours, when close monitoring is essential. First, bleeding and swelling at the surgical site may compress the trachea and lead to airway obstruction (respiratory distress), so monitoring for neck swelling and respiratory status is critical. Second, the surgery may injure the recurrent laryngeal nerve, causing vocal cord paralysis and affecting both voice and breathing, so signs of nerve injury must be assessed. In addition, thyroid surgery may inadvertently remove or damage the parathyroid glands, which regulate calcium; impaired parathyroid function can lead to hypocalcemia and tetany. During the first 24 hours postoperatively, priority assessments therefore focus on airway safety, neurologic function, and calcium balance.