— 生理適應 · MEDIUM · MCQ —
一位病患甲狀腺切除術後返回病房。哪項發現應立即告知醫師？
A client returns from a thyroidectomy. Which assessment finding should be reported to the provider immediately?
- AStridor during inhalation✓ 正解吸氣時出現喘鳴音
- BIncisional pain rated 4/10切口疼痛評分為 4/10
- CNeck swelling around the dressing敷料周圍頸部腫脹
- DHoarseness when speaking說話時聲音沙啞
— Explanation · 中文詳解 —
甲狀腺術後呼吸道通暢為第一優先。吸氣性哮鳴（Stridor）暗示喉頭水腫或喉返神經受損導致聲帶痙攣，隨時會造成呼吸道阻塞。雖 D（頸部腫脹）也危險，但 Stridor 是已經發生的呼吸道變狹窄訊號，必須立即採取行動。
Post-thyroidectomy airway patency is the top priority. Inspiratory stridor suggests laryngeal edema or recurrent laryngeal nerve damage with vocal cord spasm, which may rapidly cause airway obstruction. While D (neck swelling) is also dangerous, stridor signals that airway narrowing has already begun and requires immediate action.
✦ 台美臨床差異
美國醫院配置有甲狀腺術後專屬的緊急氣切盤（tracheostomy set）於床邊；台灣病房依醫院等級不一，但皆須將此列為高風險評估。