A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client?

Choice A rationale Brudzinski's sign is a clinical manifestation commonly assessed to identify meningeal irritation, such as in meningitis. It is elicited when passive flexion of the client's neck results in involuntary flexion of the hips and knees. This finding is unrelated to electrolyte imbalances that follow a thyroidectomy, such as hypocalcemia, which typically causes neuromuscular excitability. Choice B rationale Kernig's sign is another diagnostic indicator of meningeal irritation. It involves resistance and pain when the client's leg is fully extended at the knee while the hip is flexed at 90 degrees. This sign is specific to inflammation of the meninges, which is not the underlying cause of the client's reported paresthesia following thyroid surgery. Choice C rationale Babinski's sign, or the plantar reflex, is typically assessed in neurological examinations. A positive sign, where the great toe extends and the other toes fan out upon sole stimulation, indicates upper motor neuron damage in adults. This is unrelated to the hypocalcemia that can occur after a thyroidectomy due to parathyroid gland manipulation. Choice D rationale Chvostek's sign is a classic clinical finding for hypocalcemia, which can result from accidental parathyroid gland removal or damage during a subtotal thyroidectomy. The tingling reported by the client (paresthesia) is an early sign of hypocalcemia (normal calcium: 8.5-10.5 mg/dL), and Chvostek's sign, a twitching of the facial muscles following a tap over the facial nerve, confirms the increased neuromuscular excitability.