Chvostek Chuck — Hypocalcemia
Twitchy face, tingling lips, watch the airway
Chuck wakes from thyroid surgery with a buzzing lip and a cheek that jumps when the nurse taps it. His parathyroids took the hit, and now every nerve in his body has its volume turned up.
Chuck's calcium falls after thyroid surgery, from chronic kidney disease or from massive transfusion. Everything gets irritable: facial twitching (Chvostek's), carpal spasm (Trousseau's), tingling and, at worst, laryngospasm. Keep calcium gluconate and a trach tray nearby.
Read Chvostek Chuck's full story →The story arc
The setup
A total thyroidectomy leaves his parathyroid glands bruised and underperforming.
The turn
He reports tingling around his mouth and in his fingertips overnight.
The crisis
His cheek twitches when the nurse taps his facial nerve, his hand claws under the cuff, and then his voice turns high and crowing.
The save
IV calcium gluconate is pushed slowly on a monitor, with a tracheostomy tray at the bedside.
NCLEX study section — Hypocalcemia
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Endocrine & Metabolic
Take this chapter into practice questions on the same topic.