— 生理適應 · MEDIUM · MCQ —
使用呼吸器的病人出現哪種評估結果，顯示需要執行抽痰？
Which assessment finding in a client receiving mechanical ventilation indicates a need for suctioning?
- APatient is resting comfortably病人安靜舒適地休息
- BNormal respiratory rate of 16 breaths/min呼吸頻率正常，每分鐘16次
- CSpO2 reading of 95% on 40% FiO2在40% FiO2下SpO2讀數為95%
- DCoarse crackles heard upon auscultation✓ 正解聽診時聽到粗濕囉音
— Explanation · 中文詳解 —
抽痰的適應症為氣道分泌物蓄積，物理表現包含聽診有粗濕囉音（Coarse crackles）、呼吸音減弱、氣道壓力監測值上升或病人出現焦躁、呼吸費力。C、A、B 皆屬於穩定或正常範圍，不應進行不必要的抽痰，以減少氣管黏膜損傷。
The indication for suctioning is the accumulation of airway secretions; physical findings include coarse crackles on auscultation, diminished breath sounds, an increase in airway pressure on the monitor, or the client appearing restless or having labored breathing. C, A, and B all represent stable or normal findings and should not lead to unnecessary suctioning, which can damage the tracheal mucosa.
✦ 台美臨床差異
美國多採 PRN（視需要）抽痰以減少併發症；台灣臨床過去常採定時抽痰，現已逐漸轉向評估式抽痰。