一位甲狀腺切除術後病人，護理師量血壓時發現 Trousseau's 徵象為陽性。護理師應進一步評估哪些症狀？（選所有適合的）
A nurse is caring for a client post-thyroidectomy. The nurse notes a positive Trousseau's sign during blood pressure measurement. Which assessment findings should the nurse further investigate? (Select all that apply.)
- ALaryngeal stridor✓ 正解喉頭喘鳴
- BNumbness and tingling in the perioral area✓ 正解口周麻木與刺痛感
- CPositive Chvostek's sign✓ 正解Chvostek's 徵象陽性
- DMuscle weakness and lethargy肌肉無力與倦怠
- EGeneralized tonic-clonic seizure✓ 正解全身性強直-陣攣性抽搐
甲狀腺切除術後若出現 Trousseau's 徵象（BP 袖帶加壓後手掌痙攣），強烈暗示低血鈣，通常是因為手術過程中副甲狀腺受損或被移除。低血鈣會導致神經肌肉興奮性增加，進而引發一系列威脅生命的併發症。喉頭喘鳴（stridor）是呼吸道痙攣的警訊，隨時可能窒息，是最高優先級的危險症狀。口周麻木（perioral numbness）和 Chvostek's 徵象（輕敲面神經引起抽搐）是低血鈣的神經症狀，而嚴重的低血鈣確實可能引發全身性癲癇發作。護理師在觀察到這些徵象時，應立即備妥鈣劑，並準備好緊急呼吸道處理器械，防止病人因喉頭痙攣而窒息。這類病人必須密切監測鈣離子數值並嚴格控管神經肌肉反應。
A positive Trousseau's sign after thyroidectomy suggests hypocalcemia due to potential parathyroid gland damage, leading to increased neuromuscular excitability. The nurse should investigate symptoms such as laryngeal stridor, perioral numbness, a positive Chvostek's sign, and generalized tonic-clonic seizures, as these indicate severe hypocalcemia. Muscle weakness and lethargy are associated with hypercalcemia, not hypocalcemia.
美國護理師在術後交接班通常會直接進行 Chvostek's/Trousseau's 評估，台灣護理作業則較依賴醫師查房後的醫囑評估，對於此類術後護理的『自主預防性評估』程度在不同醫院間差異顯著。