NCLEX-RNReduction of Risk PotentialMedium
Six hours after a total thyroidectomy, a client reports a tight feeling in the throat and tingling around the mouth. The nurse notes a positive Chvostek sign. What is the nurse's priority action?
- AEncourage the client to cough and deep breathe
- BDocument the finding and reassess in one hour
- CNotify the provider and prepare to administer calcium gluconate
- DReposition the client to high Fowler's position
Show answer & explanationAnswer & explanation
Correct answer: C. Notify the provider and prepare to administer calcium gluconate
Positive Chvostek sign, perioral tingling, and throat tightness after thyroidectomy suggest hypocalcemia from inadvertent parathyroid gland injury or removal, risking laryngospasm and airway compromise. The nurse should notify the provider immediately and prepare IV calcium gluconate, keeping emergency airway equipment at the bedside.
Why the other options are wrong
- A. Coughing/deep breathing does not address impending laryngospasm from hypocalcemia.
- B. Delaying intervention risks airway obstruction from laryngospasm.
- D. Positioning alone does not treat the underlying hypocalcemia risk.
Post-Thyroidectomy Hypocalcemia
Low calcium from accidental parathyroid injury/removal during thyroid surgery, risking tetany and laryngospasm.
- Assess for Chvostek and Trousseau signs
- Symptoms: perioral tingling, muscle cramps, laryngeal spasm
- Treatment: IV calcium gluconate, keep tracheostomy tray at bedside
Memory trick: 'Chvostek cheeks twitch, calcium's low' — think parathyroid injury.