A nurse assesses a patient who is recovering from a subtotal thyroidectomy. On the first postoperative day before discharge, the patient states, "I feel numbness and tingling around my mouth.”. What action does the nurse take?

Choice A rationale Numbness and tingling around the mouth, or perioral paresthesia, is a classic sign of hypocalcemia, not a symptom to be addressed with mouth care. Offering mouth care would not address the underlying physiological issue, which is a potential disturbance in calcium levels due to accidental removal of or damage to the parathyroid glands during thyroidectomy, a serious and life-threatening complication. Choice B rationale Assessing for orientation would be an inappropriate action because the patient's symptoms are physical, not neurological, and do not suggest a change in mental status. The numbness and tingling are a specific finding pointing to a possible parathyroid gland injury and subsequent hypocalcemia. The nurse must prioritize assessment and intervention related to this critical electrolyte imbalance. Choice C rationale Muscle twitching, or neuromuscular excitability, is a hallmark sign of severe hypocalcemia. The numbness and tingling around the mouth are early indicators, and checking for muscle twitching, such as Chvostek's or Trousseau's sign, would further confirm the suspected diagnosis. This assessment is a critical and immediate step to evaluate the severity of the electrolyte imbalance and guide appropriate intervention. Choice D rationale Loosening the dressing is an action for a patient experiencing symptoms of a hematoma or airway compression, such as difficulty breathing or swelling. The patient's symptom of perioral paresthesia is related to a metabolic disturbance (hypocalcemia) and is not a sign of physical compression. Therefore, loosening the dressing would not alleviate this symptom and is an incorrect intervention.