— 基本照護與舒適 · MEDIUM · MCQ —
護理師照顧一位臨終病人，出現「死前喉鳴」（death rattle）。哪項護理措施合適？
A nurse is caring for a client who is terminally ill and experiencing 'death rattle'. Which nursing action is appropriate?
- AIncrease the IV fluid rate增加靜脈輸液速度
- BAggressively suction the oropharynx積極抽吸口咽部
- CAdminister an anticholinergic medication as ordered✓ 正解依醫囑給予抗膽鹼藥物
- DPerform vigorous chest physiotherapy執行強力的胸部物理治療
— Explanation · 中文詳解 —
死前喉鳴是由於臨終分泌物堆積所致。抗膽鹼藥物（如 Hyoscyamine 或 Scopolamine）可減少分泌物。抽吸喉嚨會讓病人更痛苦且通常無效，增加水分會導致分泌物更多，胸腔物理治療對瀕死病人不適切。
The 'death rattle' is caused by the accumulation of secretions at the end of life. Anticholinergic medications (such as hyoscyamine or scopolamine) can reduce these secretions. Aggressive oropharyngeal suctioning increases the client's distress and is usually ineffective, increasing IV fluids worsens secretions, and vigorous chest physiotherapy is inappropriate for a dying client.
✦ 台美臨床差異
美國安寧護理極重視症狀控制；台灣安寧照護進步，但對抗膽鹼藥物的給予有時受制於醫囑習慣。