A patient presents with tetany and a positive Trousseau sign. What is the immediate treatment?

• A. Administer calcium (e.g., calcium gluconate) per protocol and monitor for response.
• B. Administer potassium chloride IV and monitor.
• C. Administer magnesium sulfate IV and monitor.
• D. Administer dextrose IV and monitor.

Answer: (A)

Tetany and a positive Trousseau sign indicate acute hypocalcemia, which causes increased neuromuscular excitability. The immediate intervention is intravenous calcium replacement, such as calcium gluconate, given per protocol with close monitoring of the patient’s response and heart rhythm. Restoring calcium quickly stabilizes nerve and muscle membranes, reduces tetany, and prevents further complications.

Addressing other ions or conditions won’t rapidly correct this problem: potassium chloride would fix a potassium imbalance, not the calcium deficit; magnesium sulfate targets magnesium deficiency (which can contribute to hypocalcemia but is not the rapid fix for acute hypocalcemic tetany); dextrose addresses glucose, not calcium levels.