— 生理適應 · HARD · SATA —
護理師監測甲狀腺切除術後病人，下列哪些徵象顯示可能有低血鈣？（選所有適合的）
A nurse is monitoring a client post-thyroidectomy. Which signs indicate potential hypocalcemia? (Select all that apply.)
- APositive Trousseau's sign✓ 正解Trousseau 徵候呈陽性
- BPositive Chvostek's sign✓ 正解Chvostek 徵候呈陽性
- CLaryngeal stridor✓ 正解喉頭喘鳴
- DHyperactive deep tendon reflexes✓ 正解深部肌腱反射亢進
- EHypoactive bowel sounds腸音減弱
— Explanation · 中文詳解 —
甲狀腺切除術可能誤傷副甲狀腺導致血鈣降低。低血鈣會造成神經肌肉激惹，表現為 Trousseau 徵象、Chvostek 徵象及深部肌腱反射亢進。嚴重時會引發喉頭痙攣（Laryngeal stridor），導致呼吸道阻塞。選項 E 錯誤，低血鈣通常導致腸蠕動亢進而非減慢。
Thyroidectomy may inadvertently injure the parathyroid glands and cause hypocalcemia. Low calcium produces neuromuscular irritability, manifested as Trousseau's sign, Chvostek's sign, and hyperactive deep tendon reflexes. In severe cases, it may cause laryngeal stridor and lead to airway obstruction. Option E is incorrect because hypocalcemia generally produces hyperactive bowel sounds rather than decreased bowel sounds.
✦ 台美臨床差異
台美醫療團隊皆極為重視術後鈣離子監測，美國護理師常會備妥鈣劑於床邊，台灣則依醫囑給藥。