— 生理適應 · HARD · MCQ —
病人正發生大面積肺栓塞。護理師預期會看到哪種血流動力學變化？
A client is experiencing a massive pulmonary embolism. Which hemodynamic change does the nurse expect to see?
- ADecreased central venous pressure (CVP)中心靜脈壓 (CVP) 降低
- BIncreased systemic vascular resistance全身血管阻力增加
- CIncreased pulmonary artery pressure✓ 正解肺動脈壓增加
- DIncreased left ventricular end-diastolic pressure左心室舒張末期壓力增加
— Explanation · 中文詳解 —
大面積肺栓塞（massive pulmonary embolism, PE）是指大塊血栓阻塞了肺動脈主幹或多個肺葉動脈，導致肺循環血流嚴重受阻。其核心概念是這種阻塞會顯著增加肺血管阻力，使得右心室必須更用力地泵血才能將血液送入肺部，進而導致右心室壓力升高。這種血流動力學變化對心臟和循環系統造成巨大負擔，可能迅速導致右心衰竭和循環性休克。護理師應預期看到與右心室負荷增加和肺血管阻力升高相關的血流動力學指標變化。
A massive pulmonary embolism obstructs pulmonary blood flow, directly causing increased pulmonary artery pressure due to elevated pulmonary vascular resistance. This obstruction leads to right ventricular strain, while central venous pressure typically rises and left ventricular filling decreases.
✦ 台美臨床差異
美國護理常在加護病房直接判讀 Swan-Ganz 導管數據；台灣臨床上多由醫師判讀這些進階數值。