— 生理適應 · MEDIUM · MCQ —
一位急性胰臟炎病人的血清鈣濃度為 7.2 mg/dL。護理師應優先評估哪項生理現象？
A client with acute pancreatitis presents with a serum calcium level of 7.2 mg/dL. Which physical assessment finding should the nurse prioritize?
- AIncreased deep tendon reflexes深層肌腱反射增強
- BFlattened T-waves on ECG心電圖上 T 波平坦
- CPositive Chvostek's sign✓ 正解Chvostek 徵象陽性
- DHyperactive bowel sounds腸鳴音亢進
— Explanation · 中文詳解 —
低血鈣（正常值 8.5-10.5 mg/dL）會導致神經肌肉興奮性增加。Chvostek's sign 為輕敲臉部神經導致肌肉抽搐，是低血鈣的典型神經徵候。A（腸鳴音亢進）非低血鈣特徵；C（T 波平坦）常見於低血鉀；D（深部肌腱反射增強）雖是低血鈣表現，但 Chvostek's sign 是臨床最常用的快速篩檢指標。
Hypocalcemia increases neuromuscular excitability, making Chvostek's sign a priority assessment finding. This sign involves facial muscle twitching when the facial nerve is tapped, indicating low calcium levels. While hyperreflexia may occur, Chvostek's sign is a rapid and specific indicator of this electrolyte imbalance.
✦ 台美臨床差異
美台臨床對於低血鈣的評估工具一致，但在台醫療現場更重視血清鈣修正值的計算以判斷真偽。