— 生理適應 · MEDIUM · MCQ —
護理師監測一位 6 小時前接受甲狀腺切除術的病人。病人主訴手指及嘴周有刺痛感。護理師應先採取哪項行動？
The nurse is monitoring a client who had a thyroidectomy 6 hours ago. The client reports tingling in the fingers and around the mouth. Which action should the nurse take first?
- ACheck the client's serum calcium level測量病人的血清鈣濃度
- BAdminister oral calcium supplements給予口服鈣補充劑
- CAssess the surgical dressing for bleeding評估手術敷料是否有出血
- DAssess for Chvostek's sign✓ 正解評估 Chvostek 徵象
— Explanation · 中文詳解 —
甲狀腺切除術（thyroidectomy）後，病人主訴手指及嘴周刺痛感，這是低血鈣（hypocalcemia）的典型早期徵兆。甲狀腺切除術的一個潛在併發症是副甲狀腺（parathyroid glands）的意外損傷或切除，副甲狀腺負責調節血鈣水平。副甲狀腺功能不足會導致血鈣下降，進而引起神經肌肉興奮性增高。護理師的臨床思路應是首先透過身體評估來確認低血鈣的徵象，而不是立即給予藥物或等待檢驗結果。確認臨床徵象有助於醫師快速診斷並啟動治療。
Perioral tingling and finger numbness six hours post-thyroidectomy suggest hypocalcemia due to potential parathyroid gland damage. The nurse should first assess for Chvostek's sign to clinically confirm neuromuscular irritability before notifying the provider or administering calcium.
✦ 台美臨床差異
美國 NCLEX 考題強調先評估（Assessment first）；台灣臨床實務中，護理師常會同時準備抽血與通知醫師。