Just when you thought endocrine couldn't get any more confusing, you get a question like this:
"A patient returns from a thyroidectomy. Which of the following symptoms would indicate a complication?"
When you read the rationale and discover the answer is "tingling lips," it may baffle you. Isn't tingling lips a sign of low calcium? Let's go through why exactly this occurs.
Remember that the thyroid releases thyroid hormone (speed control in our body) while the parathyroid releases parathyroid hormone (controls calcium balance in our body). Even though these glands have similar names, they do COMPLETELY different things. Some idiot just named them "thyroid" and "parathyroid" because they're next to each other. That's it. It's like North America and South America- totally different cultures and climates, but they're next to each other.
Now, in NCLEX world, the surgeons are either pretty terrible or their patients' anatomy is seriously weird. Why? Because, sometimes, when a surgeon goes to remove their thyroid, they also take out the parathyroid gland accidentally. Whoops.
(By the way, this does not happen in real life. Ever. Ask any med/surg nurse and they will tell you this is the most ridiculous thing they've ever heard. In NCLEX world, however, it happens all the freaking time.)
Because the parathyroid gland is no longer available to release parathyroid hormone, there is no more of that hormone to pull calcium from the bones and into the bloodstream. That means that the calcium stays locked away in the bones.
Meanwhile, the blood level of calcium drops below 8 (normal range is 8-10, remember) and the patient starts to experience tingling lips, tingling or pins in needles in fingers/toes, and even possibly Trousseau's or Chvostek's signs. And it's all due to low calcium from accidental removal of the parathyroid gland in addition to the intended removal of the thyroid gland!