Certified Post Anesthesia Nurse (CPAN) Practice Exam

What signs should the perianesthesia nurse suspect in a patient post total parathyroidectomy who complains of tingling around the mouth and slight hoarseness?

1. Vocal cord irritation

2. Hypocalcemia

3. Hypercalcemia

4. Compromised airway

The correct answer is: Hypocalcemia

After a total parathyroidectomy, patients can experience a decrease in parathyroid hormone levels, leading to a drop in serum calcium levels, a condition known as hypocalcemia. The symptoms that can occur with hypocalcemia include tingling or numbness around the mouth, known as perioral tingling, as well as muscle cramps and spasms. Slight hoarseness may indicate potential laryngeal involvement, which can also occur secondary to hypocalcemia, as low calcium levels can affect neuromuscular function. Monitoring for these signs is essential in the post-operative period, as prompt identification and treatment of hypocalcemia are critical to prevent further complications. This condition may arise due to accidental removal or damage to the parathyroid glands during surgery, leading to compromised calcium regulation in the body. In this context, while vocal cord irritation and compromised airway could be concerns due to bruising or other surgical complications, the combination of tingling around the mouth and slight hoarseness aligns more closely with the signs of hypocalcemia, making it the most appropriate suspicion for the perianesthesia nurse to consider in this scenario.