護理師照護一位放置鼻胃管灌食的病人，哪些護理行為是正確的？（選所有適合的）
A nurse is caring for a client with a nasogastric tube for enteral feeding. Which actions are correct? (Select all that apply.)
- AVerify tube placement by measuring the external length透過測量外部長度來確認管路位置
- BFlush the tube with 30 mL of water before and after feeding✓ 正解在餵食前後以 30 mL 水沖洗管路
- CKeep the head of the bed elevated at 30 to 45 degrees✓ 正解保持床頭抬高 30 至 45 度
- DUse an X-ray to confirm placement after any displacement✓ 正解在任何位移後使用 X 光確認位置
- ECheck gastric residual volume every 1 hour每小時檢查胃殘留容積
鼻胃管照護核心：B. 餵食前後以 30 mL 水沖洗以維持管路通暢；C. 床頭抬高 30-45 度可預防胃食道逆流與誤吸；D. X 光是確認管路尖端位置的黃金標準。注意：A. 僅測量外露長度只能偵測管路是否移位（往外或往內滑），但無法確認管尖是否真的在胃內，依 NCLEX 2024 標準不足以單獨作為位置驗證方式；E. 每小時檢查胃殘留容積過於頻繁，現行實證已不再強調此頻率。
Core principles of nasogastric tube care: B. Flush the tube with 30 mL of water before and after feeding to maintain patency; C. Elevate the head of the bed 30-45 degrees to prevent gastroesophageal reflux and aspiration; D. X-ray is the gold standard for confirming the tip position of the tube. Note: A. Measuring only the external length of the tube can detect displacement (whether the tube has slipped outward or inward), but cannot confirm whether the tip is actually in the stomach; according to the 2024 NCLEX standard, this is insufficient to serve as the sole method of position verification. E. Checking gastric residual volume every hour is excessively frequent, and current evidence no longer emphasizes this frequency.
美國臨床實務中，對於 NG tube 的 GRV 監測頻率，醫師會根據病人情況給予明確醫囑，常見的是每 4-6 小時一次，或在特定情況下（如病人有嘔吐、腹脹等不適時）才增加頻率。台灣臨床也遵循醫囑，但部分單位可能基於習慣或嚴謹考量，指示較頻繁的監測。此外，美國對於 NG tube 的放置與移除，在某些情況下（如成人更換鼻胃管、移除已放置穩定的 NG tube），是由 RN（註冊護理師）獨立執行，而在台灣，這些操作可能需要醫師執行或 RN 在特定訓練及規範下進行。