A 38-year-old woman undergoes subtotal thyroidectomy for Graves disease refractory to medical therapy. The procedure is without incident, although the surgical dissection is relatively difficult. After a period of time in the postanesthesia care unit (PACU), the patient is transferred to a regular hospital ward. Eight hours later, the patient is irritable, complains of circumoral tingling, and develops stridor. Which of the following therapeutic interventions is most appropriate at this time?
The symptoms of circumoral tingling or numbness in association with irritability or stridor in a patient after thyroidectomy may indicate hypocalcemia due to inadvertent removal of parathyroid tissue. The difficult surgical dissection may have resulted in failure to properly identify and preserve the parathyroids. If hypocalcemia develops, it usually occurs on the evening of surgery or the day after surgery. Signs and symptoms of hypocalcemia include muscle cramps, irritability, circumoral tingling or numbness, Chvostek sign (twitching of the lip...
