護理師正在照護一位 12 小時前接受甲狀腺切除術的病人。下列哪些臨床表現顯示病人可能正在發展低血鈣？（選所有適合的）
The nurse is monitoring a client who underwent a thyroidectomy 12 hours ago. Which clinical manifestations would indicate the client is developing hypocalcemia? (Select all that apply.)
- APositive Chvostek's sign✓ 正解Chvostek 徵呈陽性
- BNumbness and tingling around the mouth✓ 正解口周麻木和刺痛
- CMuscle flaccidity肌肉弛緩
- DLaryngospasm✓ 正解喉痙攣
- EPositive Trousseau's sign✓ 正解Trousseau 徵呈陽性
甲狀腺切除術後最嚴重的併發症之一是因誤傷副甲狀腺而導致的急性低血鈣（Hypocalcemia）。低血鈣會增加神經肌肉的興奮性。Chvostek's sign（輕叩臉頰引起面肌抽搐）和 Trousseau's sign（壓脈帶充氣導致手部痙攣）是神經肌肉過度興奮的典型體徵。病人常先感到口周及肢端麻木（Paresthesia）。最危險的生理適應問題是喉痙攣（Laryngospasm），可能導致急性呼吸道阻塞。肌肉無力（Muscle flaccidity）通常與「高」血鈣或「低」血鉀相關，低血鈣反而會引起肌肉震顫或強直。護理師必須在床邊備妥 Calcium Gluconate 及氣管插管設備，以應對可能的喉痙攣急症。
One of the most serious complications after thyroidectomy is acute hypocalcemia caused by inadvertent injury to the parathyroid glands. Hypocalcemia increases neuromuscular excitability. Chvostek's sign (tapping the cheek causing facial muscle twitching) and Trousseau's sign (carpal spasm induced by inflation of a blood pressure cuff) are classic signs of neuromuscular hyperexcitability. Patients often first experience perioral and acral paresthesia. The most dangerous physiological adaptation problem is laryngospasm, which may cause acute airway obstruction. Muscle flaccidity is usually associated with hypercalcemia or hypokalemia; hypocalcemia, in contrast, causes muscle twitching or tetany. The nurse must have calcium gluconate and tracheal intubation equipment available at the bedside in case of an acute laryngospasm emergency.
在美國 NCLEX 評量中，SATA 題型常將 Trousseau's sign 與喉部安全並列，強調護理師的主動物理評估。台灣臨床護理中，術後觀察重點常放在引流管量與傷口出血，對於神經肌肉微小症狀（如口周麻木）的警覺性教育同樣重要，但設備（如床邊氣切包）的備置流程略有不同。