護理師正在監測一位甲狀腺切除術後的病人。下列哪項評估發現最能暗示病人出現了低血鈣？
The nurse is monitoring a client following a thyroidectomy. Which assessment finding is most suggestive of hypocalcemia?
- APositive Chvostek's sign✓ 正解Chvostek 徵象陽性
- BNegative Trousseau's signTrousseau 徵象陰性
- CFlaccid paralysis弛緩性麻痺
- DHyporeflexia反射減退
甲狀腺切除術後，副甲狀腺可能因受損或被誤切而導致副甲狀腺素下降，進而引發低血鈣。核心概念是識別神經肌肉興奮性增高的症狀。Chvostek's sign 指的是輕敲面神經引起的面部肌肉抽搐，是低血鈣的特徵性表現（A）。Trousseau's sign 陽性（而非陰性）也是指標之一。低血鈣會增加神經傳導的敏感度，因此會出現腱反射亢進（Hyperreflexia），而非減弱（D）。弛緩性麻痺（C）通常與高鉀或低鉀相關，而非低鈣。及早發現低血鈣能預防更嚴重的喉痙攣或抽搐併發症，這是外科術後風險管理的重要環節。
After thyroidectomy, the parathyroid glands may be damaged or inadvertently removed, leading to a drop in parathyroid hormone and resulting hypocalcemia. The core concept is recognition of increased neuromuscular excitability. Chvostek's sign refers to facial muscle twitching elicited by tapping the facial nerve and is a characteristic manifestation of hypocalcemia (A). A positive (not negative) Trousseau's sign is also an indicator. Hypocalcemia increases the sensitivity of nerve conduction, producing hyperreflexia rather than hyporeflexia (D). Flaccid paralysis (C) is associated with hyper- or hypokalemia rather than hypocalcemia. Early detection of hypocalcemia can prevent more serious complications such as laryngospasm or tetany, making it an important component of post-surgical risk management.
美國護理教育非常強調 Chvostek's 與 Trousseau's 這兩個徵象的拼寫與操作細節；台灣護理實務中亦將其視為甲狀腺術後的必考觀察重點，操作上無顯著差異，但美式考題更常將其作為優先評估項。