Medical Surgical Calcium Ca+ #6

Question

A client recovering from a thyroidectomy reports numbness and tingling around the mouth and the tips of the fingers. Which intervention should be implemented first?

Answers

  1. Notify the health care provider immediately.
    • Rationale:

      This answer is not correct because the health care provider can be notified after assessing the client for Chvostek’s sign. Notifying the health care provider immediately is not priority.

  2. Prepare to administer calcium gluconate IVP.
    • Rationale:

      This answer is not correct because the health care provider determines the medication used to treat hypocalcemia. The nurse should wait to receive orders from the health care provider after assessing the client.

  3. Check the serum calcium and magnesium levels.
    • Rationale:

      This answer is not correct because the serum calcium and magnesium levels can be assessed after checking for the Chvostek’s sign with an order from the health care provider.

  4. Tap the cheek about two centimeters anterior to the ear lobe.
    • Rationale:

      The nurse suspects hypocalcemia based on the client’s clinical data; therefore, the first action by the nurse is to assess for a positive Chvostek’s sign as this test is noninvasive and provides valuable information regarding the client’s calcium levels.

Overview

A thyroidectomy is defined as the removal of the thyroid gland. A complication associated with thyroidectomy is hypocalcemia, or decreased serum calcium levels.

Explanation

Learning Outcomes

A complication associated with thyroidectomy is hypocalcemia, or decreased serum calcium levels. Tingling and numbness around the mouth are signs of hypocalcemia. Based on the clinical data, the first action by the nurse is to assess the client for Chvostek’s sign by tapping the cheek about 2 centimeters anterior to the ear lobe. A positive sign would be twitching of the facial muscle and eyelid which indicates hypocalcemia.

Test Taking Tip

Priority indicates that while all choices may be appropriate only one should be implemented first.

Video Rationale