Medical Surgical Calcium Ca+ #3

Question

A client recovering from a thyroidectomy reports a new onset of numbness and tingling around the mouth. Which finding indicates the client’s serum calcium level is low?

Answers

  1. Confusion
    • Rationale:

      This answer is not correct because confusion is a clinical manifestation of hypercalcemia, not hypocalcemia. The nurse can specifically monitor a client for hypocalcemia by assessing the client for a positive Chvostek’s sign (i.e., ipsilateral contraction of the facial muscles).

  2. Dehydration
    • Rationale:

      This answer is not correct because dehydration is a clinical manifestation of hypercalcemia, not hypocalcemia. The nurse can specifically monitor a client for hypocalcemia by assessing the client for a positive Chvostek’s sign (i.e., ipsilateral contraction of the facial muscles).

  3. Excessive urination
    • Rationale:

      This answer is not correct because excessive urination is a clinical manifestation of hypercalcemia, not hypocalcemia. The nurse can specifically monitor a client for hypocalcemia by assessing the client for a positive Chvostek’s sign (i.e., ipsilateral contraction of the facial muscles).

  4. Positive Chvostek sign
    • Rationale:

      This answer is correct because a positive Chvostek’s sign is indicated by tapping the skin over the facial nerve approximately 2 cm anterior to the client’s external auditory meatus with ipsilateral movement noted.

Overview

Thyroidectomy is the removal of the thyroid gland and this procedure increases the client’s risk for hypocalcemia (i.e., low serum calcium levels). Calcium plays a role in maintaining homeostasis within the body.

Explanation

Learning Outcomes

Calcium plays a role in maintaining homeostasis within the body. Specifically, calcium plays an important role in nerve conduction. The nurse must monitor the client for clinical manifestations indicative of hypocalcemia (e.g., numbness and tingling, typically around the mouth, tongue, fingers and feet; bone pain; nausea; and depressed deep tendon reflexes). The nurse can specifically monitor a client for hypocalcemia by assessing the client for a positive Chvostek’s sign (i.e., ipsilateral contraction of the facial muscles).

Test Taking Tip

Consider the different clinical manifestations associated with both hypocalcemia and hypercalcemia to answer this question correctly.

Video Rationale