— 生理適應 · MEDIUM · SATA —
護理師照顧一位甲狀腺切除術後病人，下列哪些發現暗示低血鈣？（選所有適合的）
A nurse is caring for a client after a thyroidectomy. Which findings are concerning for hypocalcemia? (Select all that apply.)
- APositive Trousseau's sign✓ 正解特魯索氏徵象陽性
- BPositive Chvostek's sign✓ 正解查沃斯泰克氏徵象陽性
- CNumbness and tingling around the mouth✓ 正解口周麻木與刺痛感
- DIncreased deep tendon reflexes✓ 正解深層肌腱反射增強
- EBounding peripheral pulses周邊脈搏強而有力
— Explanation · 中文詳解 —
甲狀腺切除可能意外傷及副甲狀腺，導致鈣離子濃度下降。低血鈣常見徵象包括特魯索徵象（Trousseau's sign）、查沃斯泰克徵象（Chvostek's sign）、口周感覺異常以及深部肌腱反射亢進。選項 E 脈搏跳動增強與低血鈣無直接關聯，常與高血容或心輸出量增加有關。
Hypocalcemia after thyroidectomy presents with neuromuscular irritability, including positive Trousseau’s and Chvostek’s signs, perioral paresthesia, and hyperreflexia. These symptoms result from low calcium levels affecting nerve and muscle function. Bounding pulses are unrelated to hypocalcemia and are more commonly associated with increased cardiac output or fluid volume excess.
✦ 台美臨床差異
台灣病房常在甲狀腺術後常規備有鈣劑，美國則視監測結果而定，但兩地對這些徵象的評估標準一致。