一位病人剛結束甲狀腺切除手術返回病房，哪一項評估結果是優先考量的？
A nurse is caring for a client who has just returned from a thyroidectomy. Which assessment finding is the priority?
- APatient has a small amount of serosanguineous drainage on the dressing病人傷口敷料上有少量漿血性滲出液
- BPatient has hoarseness when speaking病人說話時聲音沙啞
- CPatient exhibits noisy, high-pitched respiratory sounds✓ 正解病人出現嘈雜且高音調的呼吸聲
- DPatient reports mild pain at the incision site病人報告切口處有輕微疼痛
甲狀腺切除後最致命的併發症是氣道阻塞，可能由喉頭水腫或血腫壓迫引起。聽見喘鳴聲（stridor）表示氣道狹窄，必須立即採取呼吸道保護措施。其他選項中，輕微疼痛、聲音嘶啞（喉返神經損傷風險）及少量滲血雖需監測，但均不如氣道阻塞具備立即致死危險，須優先處理呼吸道。
The most lethal complication following thyroidectomy is airway obstruction, which may result from laryngeal edema or compression by a hematoma. The presence of stridor signifies airway narrowing and requires immediate airway-protection measures. Among the other options, mild pain, hoarseness (suggesting risk of recurrent laryngeal nerve injury), and small amounts of serosanguineous drainage all require monitoring but are not as immediately life-threatening as airway obstruction; the airway must therefore be addressed first.
美國護理師常需負責緊急呼叫（Rapid Response Team），台灣則較多通報資深護理師或住院醫師進行處理。