護理師為甲狀腺切除術後病人進行評估,哪些發現需優先回報醫師?(選所有適合的)
A nurse is performing a postoperative assessment on a client following a thyroidectomy. Which findings should the nurse prioritize reporting to the surgeon? (Select all that apply.)
- ATingling around the mouth and fingertips✓ 正解嘴脣和指尖周圍有刺痛感
- BHoarseness of the voice聲音嘶啞
- CDifficulty breathing with stridor✓ 正解伴隨哮鳴音的呼吸困難
- DTachycardia and high fever✓ 正解心搏過速和高燒
- EMild incisional pain at the surgical site手術部位輕微切口疼痛
甲狀腺手術後併發症具高度危險性。口周與指尖刺痛暗示低血鈣(副甲狀腺損傷);呼吸困難合併哮鳴音(Stridor)暗示喉頭水腫,有窒息風險;心搏過速與高燒暗示甲狀腺風暴。聲音嘶啞(B)常見但通常是暫時性喉返神經刺激。輕微切口痛(E)為術後預期反應,非優先處理事項。
Complications after thyroid surgery can be very dangerous. Tingling around the mouth and fingertips suggests hypocalcemia (parathyroid injury); difficulty breathing with stridor suggests laryngeal edema and an imminent airway compromise; and tachycardia with high fever suggests thyroid storm. Hoarseness (B) is common but usually transient, due to recurrent laryngeal nerve irritation. Mild incisional pain (E) is an expected postoperative finding and not a priority concern.
美國護理師常執行 Chvostek's 與 Trousseau's sign 檢測;台灣護理師多透過監測實驗室數據評估鈣離子狀況。