護理師照顧一位 12 小時前接受全甲狀腺切除術的病人。下列哪項發現需要立即介入處置？
A nurse is caring for a client who had a total thyroidectomy 12 hours ago. Which finding requires immediate intervention?
- AHoarse voice when speaking說話時聲音沙啞
- BSore throat when swallowing吞嚥時喉嚨痛
- CPositive Trousseau's sign✓ 正解Trousseau 徵象陽性
- DPain at the incision site切口處疼痛
甲狀腺切除術可能誤傷副甲狀腺，導致低血鈣。正向的 Trousseau's sign（壓脈帶充氣後手部抽搐）是低血鈣引發神經肌肉過度興奮的徵象，可能導致喉頭痙攣及呼吸停止。沙啞可能是喉返神經受損，但低血鈣導致的痙攣更具立即生命威脅。喉嚨痛與傷口痛為預期後果。
Thyroidectomy can inadvertently injure the parathyroid glands, leading to hypocalcemia. A positive Trousseau's sign (carpal spasm after blood pressure cuff inflation) reflects neuromuscular hyperexcitability from hypocalcemia and can lead to laryngospasm and respiratory arrest. Hoarseness may indicate recurrent laryngeal nerve injury, but spasm caused by hypocalcemia poses a more immediate threat to life. Sore throat and incisional pain are expected postoperative findings.
美國 NCLEX 考題強調 ABCs 與生命安全；台灣臨床實務對低血鈣評估（Chvostek/Trousseau）亦非常重視，常列為交班重點。