— 生理適應 · MEDIUM · SATA —
護理師監測甲狀腺切除術後病人。哪些發現需立即通知外科醫師？（選所有適合的）
A nurse is monitoring a client post-thyroidectomy. Which findings should the nurse report to the surgeon immediately? (Select all that apply.)
- AHoarseness of the voice聲音嘶啞
- BStridor during inspiration✓ 正解吸氣時出現喘鳴音
- CNeck swelling and dressing saturation✓ 正解頸部腫脹及敷料滲透
- DPatient reports pain at the incision site病人報告切口處疼痛
- ENumbness and tingling around the mouth✓ 正解口周麻木及刺痛感
— Explanation · 中文詳解 —
甲狀腺切除術後需優先處理呼吸道阻塞（喘鳴音、頸部腫脹）與低血鈣（口周麻木）。喘鳴代表呼吸道受壓，血腫可能壓迫氣管；口周麻木則是誤傷副甲狀腺導致血鈣降低的早期症狀，皆需緊急處置。聲音沙啞雖需注意，但非立即危及生命的急症。
Stridor and neck swelling indicate potential airway obstruction from hematoma, requiring immediate surgical intervention. Additionally, perioral numbness suggests hypocalcemia due to parathyroid injury, which is another critical postoperative complication that must be reported promptly.
✦ 台美臨床差異
台灣醫院對甲狀腺術後呼吸音的監測通常有嚴格交班規範，美國則更著重於護理師的主動臨床警覺評估（Clinical judgment）。