— 降低風險 · HARD · SATA —
護理師照護甲狀腺切除術後病人，下列哪些評估最為優先？（選所有適合的）
A nurse is caring for a client who is post-operative following a thyroidectomy. Which assessments are priority? (Select all that apply.)
- AAssess the voice for hoarseness✓ 正解評估聲音是否有沙啞
- BMonitor for Chvostek's sign✓ 正解監測 Chvostek 徵象
- CCheck for neck swelling and respiratory distress✓ 正解檢查是否有頸部腫脹和呼吸困難
- DAssess the client's ability to swallow評估個案的吞嚥能力
- EMonitor for signs of hypocalcemia✓ 正解監測低血鈣的徵兆
— Explanation · 中文詳解 —
甲狀腺切除術後致命併發症包括氣管壓迫（出血導致腫脹）、喉返神經損傷（聲音沙啞）及副甲狀腺誤傷（低血鈣）。Chvostek's sign 與低血鈣直接相關，需列入評估。吞嚥能力雖需評估，但並非術後初期導致生命徵象改變的核心風險。
Life-threatening complications after thyroidectomy include tracheal compression (from bleeding-induced swelling), recurrent laryngeal nerve injury (hoarseness), and inadvertent parathyroid injury (hypocalcemia). Chvostek's sign is directly associated with hypocalcemia and must be included in the assessment. Although swallowing ability should be evaluated, it is not the core risk for vital-sign changes in the early postoperative period.
✦ 台美臨床差異
美台臨床皆強調甲狀腺術後的氣道保護，但台灣醫院對於副甲狀腺功能監測通常會安排較頻繁的血鈣抽血檢查。