— 生理適應 · MEDIUM · MCQ —
護理師監測甲狀腺切除術後的病人，發現其出現手足抽搐與口周麻木。護理師應如何解讀此發現？
A nurse is monitoring a client post-thyroidectomy. The client exhibits carpopedal spasms and circumoral numbness. What is the nurse's priority interpretation?
- AHyponatremia secondary to SIADH繼發於抗利尿荷爾蒙分泌不適當症候群（SIADH）的低血鈉症
- BHypermagnesemia from surgical stress手術壓力導致的高血鎂症
- CHypokalemia related to metabolic alkalosis與代謝性鹼中毒相關的低血鉀症
- DHypocalcemia due to accidental parathyroid removal✓ 正解因意外切除副甲狀腺引起的低血鈣症
— Explanation · 中文詳解 —
甲狀腺切除術中若誤傷副甲狀腺，會導致副甲狀腺素（PTH）分泌減少，引起血鈣降低（Hypocalcemia）。典型徵象為 Trousseau's sign（手足抽搐）與 Chvostek's sign（顏面神經興奮），口周麻木則是低鈣血症的早期神經症狀。
If the parathyroid glands are inadvertently injured during thyroidectomy, parathyroid hormone (PTH) secretion decreases, causing hypocalcemia. Typical findings include Trousseau's sign (carpopedal spasm) and Chvostek's sign (facial nerve hyperexcitability); circumoral numbness is an early neurologic symptom of hypocalcemia.
✦ 台美臨床差異
台美臨床皆極重視術後鈣離子監測，美國護理師常執行 Trousseau's sign 評估，台灣則更依賴抽血數值。