# 一位甲狀腺切除術後8小時的個案主訴嘴巴周圍有刺痛感，且Chvostek氏徵象呈陽性。護理師應預期採取哪項行動？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397337&lang=zh-tw  
> language: zh-TW  
> subject: Postsurgical Complications  
> category: ROR

## 題目

一位甲狀腺切除術後8小時的個案主訴嘴巴周圍有刺痛感，且Chvostek氏徵象呈陽性。護理師應預期採取哪項行動？

## 選項

1. 鼓勵個案對著紙袋深呼吸。
2. 準備依醫囑給予靜脈注射葡萄糖酸鈣。 **✔ 正確答案**
3. 給予高磷口服補充劑。
4. 讓個案平躺，且身邊不放置呼吸道設備。

**正確答案: 2**

## 解析

甲狀腺切除術後出現刺痛感及Chvostek氏徵象陽性，暗示因副甲狀腺受損導致的低血鈣。若症狀顯著，可能需要靜脈注射葡萄糖酸鈣。由於強直可能進展，呼吸道準備也很重要。磷會加劇低血鈣。

## 深入解析

臨床判斷
利用個案線索、時間點、檢驗數據及安全風險，選擇最符合甲狀腺切除術後低血鈣的處置。

記憶提示
將最強的線索群與最安全的護理判斷配對。

KR vs US
NCLEX考題獎勵基於線索的優先思考，而非單獨的記憶提取。

## 臨床情境

臨床實務指引
針對甲狀腺切除術後低血鈣，將完整的線索模式與個案當前的穩定性、醫囑數據及預期的護理範圍進行比較。

注意
當完整情境改變了優先次序或安全性時，不要僅根據單一線索選擇行動。

## 重要概念

- **Chvostek氏徵象** — 輕敲顏面神經後出現的臉部肌肉抽搐，與低血鈣相關。
- **低血鈣** — 血清鈣過低，可能導致神經肌肉易受刺激。
- **葡萄糖酸鈣** — 用於症狀性低血鈣的鈣補充劑。

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