Certified Post Anesthesia Nurse (CPAN) Practice Exam

After noticing tingling and hoarseness in a patient post total parathyroidectomy, what should the perianesthesia nurse's next action be?

1. Instruct the patient to remain silent to rest vocal cords

2. Have the patient say "e" to check for nerve damage

3. Call the surgeon and anticipate an order to check for calcium level

4. Administer pain medication and look for signs of hemorrhage

The correct answer is: Call the surgeon and anticipate an order to check for calcium level

The most appropriate action in this situation is to call the surgeon and anticipate an order to check for calcium levels. After a total parathyroidectomy, the parathyroid glands, which regulate calcium levels in the body, may be impaired, leading to hypocalcemia. Tingling sensations and hoarseness can indicate this condition, as low calcium levels can affect nerve function and muscle contraction, including muscles involved in speech. Monitoring calcium levels is crucial because untreated hypocalcemia could lead to severe complications, such as tetany or cardiac issues. Therefore, responding to the early signs of potential hypocalcemia by consulting the surgeon is critical for patient safety and timely intervention. While other options might address immediate symptoms, they do not target the underlying concern associated with the surgical procedure and the symptoms observed. For instance, instructing the patient to remain silent or performing vocal cord assessments do not address the vital need to assess calcium levels. Additionally, administering pain medication or checking for signs of hemorrhage, while potentially necessary, may overlook the significant risk of hypocalcemia posed directly after parathyroid surgery.