— 生理適應 · HARD · MCQ —
一位個案診斷為急性呼吸窘迫症候群 (ARDS)。下列何項護理措施對確保足夠氧合最為關鍵？
A client is diagnosed with acute respiratory distress syndrome (ARDS). Which nursing action is most critical to ensure adequate oxygenation?
- APlacing the client in a prone position✓ 正解將個案置於俯臥位
- BAdministering intravenous diuretics給予靜脈注射利尿劑
- CMaintaining strict fluid restriction維持嚴格的水分限制
- DIncreasing the tidal volume on the ventilator增加呼吸器的潮氣容積
— Explanation · 中文詳解 —
ARDS 的特徵是肺泡塌陷與嚴重的通氣/灌流不均。俯臥姿態（Prone positioning）能改變重力分佈，使背側肺泡重新張開，改善通氣並減少心臟對肺部的壓迫，對於難治性低氧血症是經證實有效的關鍵治療。
ARDS is characterized by alveolar collapse and severe ventilation/perfusion mismatch. Prone positioning alters the distribution of gravity, reopens dorsal alveoli, improves ventilation, and reduces the cardiac pressure on the lungs; it is a proven, key therapy for refractory hypoxemia.
✦ 台美臨床差異
兩地均依實證指引執行俯臥位，但美國加護病房較常設有專責翻身團隊與相關翻身床技術。