A patient who underwent subtotal thyroidectomy is experiencing muscle cramps and tingling around the mouth. Which interventions should the nurse prioritize? (Select all that apply)

Post-thyroidectomy clients are at risk of hypocalcemia due to accidental removal or trauma to the parathyroid glands. This leads to decreased parathyroid hormone causing hypocalcemia, neuromuscular excitability, tetany, and potentially life-threatening laryngospasm and seizures. Rationale: A. High-protein, high-carbohydrate diet does not correct hypocalcemia or neuromuscular irritability. Nutritional modification is not an acute priority intervention in postoperative parathyroid insufficiency and does not prevent tetany or airway compromise. B. Airway monitoring is critical because hypocalcemia may cause laryngospasm and airway obstruction due to increased neuromuscular excitability. Early detection of stridor or respiratory distress is essential to prevent acute respiratory compromise. C. Thyroid hormone replacement addresses postoperative hypothyroidism, not acute hypocalcemia. The presenting symptoms of perioral tingling and muscle cramps are related to calcium deficiency, not thyroid hormone insufficiency. D. Intravenous calcium gluconate directly corrects serum calcium deficit, stabilizing neuromuscular membranes and reversing tetany. It is the immediate pharmacologic treatment for symptomatic hypocalcemia following thyroid surgery. E. Seizure precautions are required due to increased neuronal excitability from hypocalcemia. Low calcium levels can precipitate generalized seizures, so safety measures such as padded rails and airway protection are necessary. F. Cooling blankets are used for hyperthermia management, not hypocalcemia. The client’s symptoms are due to neuromuscular irritability from low calcium, making temperature reduction irrelevant and inappropriate.