Editing Medical-Surgical Nursing – RN Practice Questions (section)

==Question 14==
Four hours after a total thyroidectomy, a patient reports tingling around the mouth and in the fingertips, and carpal spasm occurs when the blood pressure cuff is inflated. What should the nurse anticipate?
# Administration of intravenous calcium gluconate for hypocalcemia.
# Administration of intravenous levothyroxine for myxedema.
# Application of a cooling blanket for thyroid storm.
# Administration of potassium chloride for hypokalemia.

'''Answer:''' Option 1, administration of intravenous calcium gluconate for hypocalcemia.

''Rationale:'' Perioral and fingertip paresthesia with a positive Trousseau sign indicates acute hypocalcemia, which occurs when the parathyroid glands are injured or inadvertently removed during thyroidectomy. Untreated, it progresses to tetany, laryngospasm, and seizures, so calcium replacement and continued airway vigilance are the priorities. Option 2 describes severe hypothyroidism, which does not develop within hours. Option 3 describes thyroid storm, which presents with high fever, severe tachycardia, and agitation. Option 4 does not match the findings.