— 降低風險 · EASY · MCQ —
一位接受髖關節置換術後的病患，護理師採取下列哪項措施以優先降低肺栓塞風險？
A nurse is caring for a client who is post-operative following a hip arthroplasty. Which action by the nurse is the priority to reduce the risk of pulmonary embolism?
- AMonitoring the client's intake and output監測案主的出入量
- BAssessing the surgical incision site評估手術切口部位
- CEncouraging early ambulation✓ 正解鼓勵早期下床活動
- DAdministering oral pain medication給予口服止痛藥物
— Explanation · 中文詳解 —
深部靜脈栓塞（DVT）是髖關節手術後的重大併發症，進而可能導致肺栓塞。早期下床活動可促進下肢血液循環，防止靜脈血液淤積，是預防血栓最有效的非藥物物理措施。其餘選項雖為護理照護的一部分，但對於預防肺栓塞的直接效益不如活動。
Deep vein thrombosis (DVT) is a major complication after hip surgery and can lead to pulmonary embolism. Early ambulation promotes circulation in the lower extremities and prevents venous stasis, making it the most effective non-pharmacologic, physical measure for thrombosis prevention. The other options are part of nursing care but provide less direct benefit for preventing pulmonary embolism than mobilization.
✦ 台美臨床差異
美國護理師常配合醫囑主導早期活動協議；台灣臨床則常因疼痛恐懼或引流管顧慮，早期下床活動較為保守。