The nurse is caring for a child with hypoparathyroidism who demonstrates a carpal spasm when pressure is applied to the upper arm. Which laboratory value should the nurse review?
A.
Potassium.
B.
Chloride.
C.
Sodium.
D.
Calcium.
The correct answer and Explanation is :
The correct answer is D. Calcium.
The child demonstrating a carpal spasm when pressure is applied to the upper arm is showing a positive Trousseau’s sign, which is a classic indicator of hypocalcemia (low calcium levels). Trousseau’s sign occurs when there is involuntary muscle contraction in the hand or wrist due to decreased calcium levels, leading to increased neuromuscular excitability. This spasm is elicited by occluding the brachial artery with a blood pressure cuff, causing ischemia and neuromuscular irritability.
In the case of hypoparathyroidism, the parathyroid glands produce insufficient parathyroid hormone (PTH), which plays a crucial role in regulating calcium and phosphate levels in the blood. PTH helps raise blood calcium levels by stimulating calcium release from bones, increasing calcium absorption in the intestines, and decreasing calcium loss through the kidneys. When PTH levels are low, calcium levels in the blood also drop, leading to hypocalcemia.
The symptoms of hypocalcemia include:
- Muscle spasms or cramps (like the carpal spasm seen with Trousseau’s sign)
- Tingling or numbness in the extremities
- Seizures in severe cases
- Positive Chvostek’s sign (facial muscle spasm when the facial nerve is tapped)
Other electrolytes, such as potassium (A), chloride (B), and sodium (C), do not have a direct role in the symptoms associated with hypoparathyroidism. While these electrolytes are essential for overall health, their levels are not directly linked to the neuromuscular excitability observed in hypocalcemia.
Therefore, the nurse should focus on reviewing the calcium level, as this value will provide critical information for the diagnosis and management of the child’s condition.