護理師監測甲狀腺切除術後病人。因不慎移除副甲狀腺最可能導致哪種電解質失衡？
A nurse is monitoring a client post-thyroidectomy. Which electrolyte imbalance is most likely to occur due to accidental parathyroid removal?
- AHypomagnesemia低鎂血症
- BHypocalcemia✓ 正解低血鈣症
- CHyperkalemia高血鉀症
- DHypernatremia高血鈉症
本題的核心概念是甲狀腺切除術（thyroidectomy）後可能發生的併發症，特別是與副甲狀腺（parathyroid glands）相關的電解質失衡。副甲狀腺通常位於甲狀腺的背面或附近，負責分泌副甲狀腺素（parathyroid hormone, PTH）。PTH的主要功能是調節血鈣和血磷水平，當血鈣降低時，PTH會促進骨骼釋放鈣、腎臟重吸收鈣並活化維生素D以增加腸道鈣吸收，從而升高血鈣。在甲狀腺切除術中，副甲狀腺可能因手術創傷、血液供應受損或不慎被移除，導致PTH分泌不足，進而引發低血鈣症（hypocalcemia）。
The parathyroid glands regulate calcium levels through the secretion of parathyroid hormone (PTH). Accidental removal or damage to these glands during thyroidectomy results in decreased PTH, leading to hypocalcemia. Nurses must monitor for signs of low calcium, such as tetany or Chvostek’s sign, as this is a common and serious postoperative complication.
美國術後觀察重點包含床邊備妥氣管切開包與葡萄糖酸鈣；台灣床邊準備項目依各院規定略有不同。