— 降低風險 · MEDIUM · MCQ —
護理師照護一位剛進行甲狀腺切除術的病人。下列哪項發現是護理師需優先回報給外科醫生的最高優先級？
A nurse is caring for a client who has just returned from a thyroidectomy. Which finding is the highest priority for the nurse to report to the surgeon?
- AHoarseness when speaking說話時聲音沙啞
- BDrowsiness from anesthesia因麻醉而嗜睡
- CPain at the incision site切口處疼痛
- DBilateral laryngeal stridor✓ 正解雙側喉頭喘鳴
— Explanation · 中文詳解 —
甲狀腺切除術後，雙側喉喘鳴（laryngeal stridor）強烈暗示喉頭水腫或聲帶麻痺，可能導致嚴重的氣道阻塞，屬於緊急呼吸窘迫情況，必須立即介入以維護通暢氣道。其他選項雖然需要監測，但均不如氣道阻塞具有立即的生命威脅。
After a thyroidectomy, bilateral laryngeal stridor strongly suggests laryngeal edema or vocal cord paralysis, which may lead to severe airway obstruction. This constitutes acute respiratory distress and requires immediate intervention to maintain a patent airway. Although the other options also require monitoring, none pose the immediate life-threatening risk associated with airway obstruction.
✦ 台美臨床差異
台美對甲狀腺術後監測均極為嚴格，美國護理師常執行床邊喉鏡檢查評估，台灣則由耳鼻喉科醫師協助評估。