— 生理適應 · EASY · MCQ —
一位 45 歲急性胰臟炎病人感到嚴重腹痛。下列何者為緩解其生理反應的優先介入措施？
A 45-year-old client with a history of acute pancreatitis is experiencing severe abdominal pain. Which intervention is the highest priority to manage the client's physiological response?
- AMaintain NPO status維持禁食狀態
- BMonitor blood glucose levels監測血糖水平
- CAdminister IV morphine as prescribed✓ 正解依醫囑給予靜脈注射嗎啡
- DPlace the client in a side-lying position將病人置於側臥姿勢
— Explanation · 中文詳解 —
急性胰臟炎的劇烈疼痛會引發交感神經興奮，增加代謝需求與休克風險。止痛是優先護理目標，以緩解疼痛引起的生理壓力。NPO（禁食）雖能減少胰液分泌，但止痛對於緩解病人急性窘迫更為急迫，能有效降低疼痛導致的應激反應。
The severe pain of acute pancreatitis triggers sympathetic activation, increasing metabolic demand and the risk of shock. Pain control is the priority nursing goal in order to alleviate the physiologic stress caused by pain. Although NPO status reduces pancreatic secretion, pain relief is more urgent for alleviating acute distress and effectively reduces the stress response.
✦ 台美臨床差異
美國護理師依醫囑給予 PCA 或 IV 止痛劑；台灣臨床護理師常需更嚴格遵守給藥常規，需即時評估止痛效果。