— 基本照護與舒適 · MEDIUM · MCQ —
護理師照顧一位留置鼻胃管的病人。在開始灌食前，哪種方法確認管路位置最可靠？
A nurse is caring for a client with a nasogastric (NG) tube. What is the most reliable method to verify tube placement before initiating a feeding?
- ATesting the pH of aspirated gastric content✓ 正解測試抽吸出的胃內容物之 pH 值
- BAuscultating for air gurgling in the stomach聽診胃部是否有空氣泡聲
- CChecking the measurement marking at the nostril檢查鼻孔處的測量標記
- DInjecting 30 mL of air注入 30 mL 空氣
— Explanation · 中文詳解 —
確認鼻胃管放置位置最可靠的金標準為 X 光攝影，其次為測量抽出液的 pH 值。氣泡測試（B/D）已被實證無法區分管路是在胃部還是氣管內，極不安全。測量標記（C）僅能做為輔助參考，不能保證管路末端位置。
The most reliable gold standard for confirming nasogastric tube placement is X-ray imaging, followed by testing the pH of aspirated contents. The air auscultation method (B/D) has been evidence-based shown to be incapable of distinguishing whether the tube is in the stomach or the trachea, and is highly unsafe. The external measurement marking (C) can only serve as a supplementary reference and cannot guarantee the position of the tube tip.
✦ 台美臨床差異
台灣部分臨床單位仍保留聽診法，但國際醫學指引已明確指出應廢除，兩地均在往標準化指標邁進。