Weight loss, nervousness, and tachycardia Show Weight loss, nervousness, and tachycardia are signs of hyperthyroidism. Other signs of hyperthyroidism include exophthalmos, diaphoresis, fever, and diarrhea. Weight gain, constipation, lethargy, decreased sweating, and cold intolerance are signs of hypothyroidism. Thyroid crisis Thyroid crisis usually occurs in the first 12 hours after thyroidectomy and causes exaggerated signs of hyperthyroidism, such as high fever, tachycardia, and extreme restlessness. Diabetic ketoacidosis is more likely to produce polyuria, polydipsia, and polyphagia. Hypoglycemia is likely to produce weakness, tremors, profuse perspiration, and hunger. Tetany typically causes uncontrollable muscle spasms, stridor, cyanosis, and possibly asphyxia. Positive Chvostek's sign If a nurse taps the client's facial nerve (which lies under the tissue in front of the ear), the client's mouth twitches and the jaw tightens. The response is identified as a positive Chvostek's sign. The nurse may elicit a positive Trousseau's sign by placing a BP cuff on the upper arm, inflating it between the systolic and diastolic BP, and waiting 3 minutes. The nurse observes the client for spasm of the hand (carpopedal spasm), which is evidenced by the hand flexing inward. Deep tendon reflexes include the biceps, brachioradialis, triceps, and patellar reflexes. Tetany would be manifested by reports of numbness and tingling in the fingers or toes or around the lips, voluntary movement that may be followed by an involuntary, jerking spasm, and muscle cramping. Tonic (continuous contraction) flexion of an arm or a finger may occur. What do Chvostek and Trousseau signs indicate?Chvostek's sign is de- scribed as the twitching of facial muscles in response to tapping over the area of the facial nerve (Video 1). Trousseau's sign is carpopedal spasm that results from ischemia, such as that induced by pressure applied to the upper arm from an in- flated sphygmomanometer cuff (Video 2).
What does a positive Chvostek's sign indicate?If the Chvostek sign is positive, ipsilateral twitching of the facial muscles occurs, whereas there is no movement when the sign is negative. A positive Chvostek sign may indicate hypocalcemia or other electrolyte imbalances, as well as severe conditions, like kidney failure or acute pancreatitis.
Why does hypocalcemia cause Chvostek sign?A positive Chvostek's sign can be a sign of hypocalcemia (low calcium level in the blood), because this condition leads to nerve and muscle irritability. A normal calcium level in the blood is 8.5-10.5 mg/dL so a patient may demonstrate a positive Chvostek sign at a level less than 8.5 mg/dL.
For Which complication would the nurse use Chvostek's sign and Trousseau's sign to assess during the first 72 hours after a client has had a thyroidectomy?The development of carpal spasms upon inflation of the blood pressure cuff is a classic sign of hypocalcemia and is known as Trousseau sign. Chvostek sign is the other classic sign of hypocalcemia and is elicited by tapping the facial nerve in the preauricular area causing spasm of the facial muscles.
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Which hormonal disorder may be suspected when positive chvostek and Trousseau signs are assessed?
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