— 安全與感染控制 · HARD · MCQ —
護理師交班後應優先評估哪位病人？
Which client should the nurse assess first after receiving the morning shift report?
- AA 60-year-old client with a history of COPD complaining of shortness of breath有慢性阻塞性肺病病史且主訴呼吸困難的60歲病人
- BA 45-year-old client with a fever of 101.2°F (38.4°C) after surgery術後體溫38.4°C（101.2°F）的45歲病人
- CA 25-year-old client with a fractured leg who reports increased pain and tingling✓ 正解腿部骨折且報告疼痛加劇與刺痛感的25歲病人
- DA 75-year-old client awaiting discharge to a long-term care facility等待轉介至長期照護機構的75歲病人
— Explanation · 中文詳解 —
優先順序評估 (Prioritization)。C 選項的疼痛增加且伴隨麻木感（tingling）是腔室症候群（Compartment Syndrome）的早期徵兆，這屬於神經血管急症，若不立即處理可能導致永久性損傷。A（發燒）、A（COPD喘）雖重要但較預期；D（出院）最不緊急。
Prioritization is the key concept. Option C, increased pain accompanied by tingling, is an early sign of compartment syndrome, a neurovascular emergency that can lead to permanent damage if not treated immediately. Although A (fever) and A (COPD shortness of breath) are important, they are within expected findings; D (awaiting discharge) is the least urgent.
✦ 台美臨床差異
美國 NCLEX 考試極重視「神經血管評估」(Neurovascular check)；台灣交班通常先看重症或新入病人，但對潛在腔室症候群的警覺性教育是共通的。