護理師照護一位疑似深部靜脈栓塞（DVT）的病人，哪些發現支持此診斷？（選所有適合的）
A nurse is caring for a client with suspected deep vein thrombosis (DVT). Which findings support this diagnosis? (Select all that apply.)
- AUnilateral calf pain✓ 正解單側小腿疼痛
- BWarmth over the affected area✓ 正解患部皮膚溫熱
- CPitting edema in the affected limb✓ 正解患肢出現凹陷性水腫
- DDiminished pedal pulses足背動脈搏動減弱
- EPositive Homans signHomans 徵象陽性
深部靜脈栓塞（DVT）的診斷基於 Virchow's triad（血液淤滯、血管內皮損傷、血液高凝狀態）。臨床評估著重於患肢的血液回流障礙與發炎反應。護理師應評估單側肢體是否有腫脹、壓痛及發熱。現代臨床已不建議主動執行 Homans sign，因其敏感度與特異度極低，且可能導致血栓脫落造成肺栓塞（PE）。
The diagnosis of deep vein thrombosis (DVT) is based on Virchow's triad (stasis of blood, vascular endothelial injury, and hypercoagulability). Clinical assessment focuses on impaired venous return and inflammation in the affected limb. The nurse should assess for unilateral swelling, tenderness, and warmth. Modern clinical practice no longer recommends actively performing Homans' sign, as its sensitivity and specificity are very low and it may dislodge a thrombus, causing pulmonary embolism (PE).
在美國臨床實務中，Homans sign 已被視為不具診斷價值且具風險的評估方式，教學中會強調應使用 Wells Criteria 評估臨床機率，而非仰賴單一物理檢查。