— 生理適應 · EASY · MCQ —
護理師評估一位急性膽囊炎病人。預期會出現什麼臨床表現？
A nurse is assessing a client with acute cholecystitis. Which clinical manifestation should the nurse expect?
- ALeft lower quadrant pain with fever左下腹疼痛伴隨發燒
- BColicky pain in the lower abdomen with diarrhea絞痛性下腹痛伴隨腹瀉
- CBurning epigastric pain relieved by food進食後緩解的上腹部燒灼痛
- DRight upper quadrant pain radiating to the right shoulder✓ 正解右上腹疼痛並放射至右肩
— Explanation · 中文詳解 —
急性膽囊炎常見症狀為右上腹疼痛，常會放射至右肩或右肩胛骨區（稱為 Murphy's sign）。這是因為膽囊發炎刺激膈神經的轉移痛。其他選項描述的是憩室炎、胃潰瘍或腸胃炎的特徵，與膽囊炎症狀明顯不同。
A common symptom of acute cholecystitis is right upper quadrant pain that frequently radiates to the right shoulder or the area of the right scapula (associated with Murphy's sign). This results from referred pain to the phrenic nerve caused by the inflamed gallbladder. The other options describe features of diverticulitis, peptic ulcer disease, or gastroenteritis and are clearly different from the manifestations of cholecystitis.
✦ 台美臨床差異
台美兩地對於膽囊炎術前評估皆高度依賴超音波，但台灣健保給付超音波極為普及，確診流程通常極快。