(^338) Medical-Surgical Nursing Demystified
- Check for Trousseau’s sign (inflate blood pressure cuff on the arm and mus-
cles contract). - Check for Chvostek’s sign (tapping of the facial nerve causes twitching of
the facial muscles). Both this sign and Trousseau’s sign are positive when the
parathyroid glands have been manipulated during thyroid surgery, in which
case they secrete too much phosphorus and not enough calcium. Since mus-
cles, i.e. the heart, need calcium for work, a low calcium level may cause
muscle spasms which are easily detected by Chvostek’s sign and Trousseau’s
sign. The treatment is IV calcium, administered quickly.
Simple Goiter
WHAT WENT WRONG?
A lack of iodine in the patient’s diet (endemic, simple goiter) causes the thyroid
gland to become enlarged. This is seen less today because iodine is added to
table salt. The thyroid gland can also become enlarged by ingesting large amounts
of goitrogenic drugs or goitrogenic foods that decrease production of thyroxine,
such as strawberries, cabbage, peanuts, peas, peaches, and spinach. This results
in sporadic simple goiter. A simple goiter is not caused by inflammation or
neoplasm.PROGNOSIS
Prognosis is good if treated and patients go on to live normal lives.HALLMARK SIGNS AND SYMPTOMS
- Difficulty in swallowing (dysphagia) due to a large thyroid pressing on the
esophagus - Enlarged thyroid gland
- Respiratory distress from the large gland, causing pressure on the trachea
- A tight feeling in the throat from a large gland
- Coughing
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