— 生理適應 · HARD · MCQ —
護理師照護一位甲狀腺切除術後病人，發現其出現肌肉抽搐、口周麻木及 Trousseau's 徵象陽性。護理師應懷疑什麼？
A nurse is caring for a client post-thyroidectomy who develops sudden muscle twitching, numbness around the mouth, and a positive Trousseau's sign. What should the nurse suspect?
- AHypocalcemia✓ 正解低血鈣
- BHyponatremia低血鈉
- CHypermagnesemia高血鎂
- DHyperkalemia高血鉀
— Explanation · 中文詳解 —
甲狀腺切除術中可能誤傷副甲狀腺，導致副甲狀腺素（PTH）分泌不足，引發低血鈣。Trousseau's 徵象與口周麻木是典型的低血鈣神經肌肉興奮性增加表現。高鉀血症通常表現為心律不整；低鈉則表現為精神狀態改變；高鎂會抑制神經傳導，與題述症狀相反。
The nurse should suspect hypocalcemia, which often results from accidental injury to the parathyroid glands during thyroid surgery. This condition leads to decreased parathyroid hormone levels, causing neuromuscular irritability manifested by muscle twitching, perioral numbness, and a positive Trousseau's sign.
✦ 台美臨床差異
美國護理師常需自行執行並判讀 Trousseau's 與 Chvostek's 徵象，台灣護理師執行頻率較低，多由醫師評估。