— 降低風險 · HARD · MCQ —
護理師照顧一位進行腰椎穿刺的病人，哪項發現是需立即處理的嚴重併發症？
A nurse is caring for a client undergoing a lumbar puncture. Which finding would be considered a major complication requiring immediate intervention?
- ANumbness and tingling in the lower extremities✓ 正解下肢麻木和刺痛
- BBlood-tinged drainage from the site穿刺部位有帶血的引流液
- CMild headache when sitting up坐起時輕微頭痛
- DLocalized tenderness at the puncture site穿刺部位局部壓痛
— Explanation · 中文詳解 —
腰椎穿刺後，若病人出現雙下肢麻木、刺痛或運動功能障礙，這可能是脊髓損傷或脊椎內血腫壓迫神經的徵兆，屬於神經系統損害的紅色警訊。其他選項如穿刺點疼痛、術後頭痛或輕微滲血均為常見且預期內的副作用，通常透過臥床休息即可緩解。
After a lumbar puncture, if the patient develops numbness, tingling, or motor deficits in the lower extremities, this may indicate spinal cord injury or an epidural hematoma compressing nerves, which is a red-flag sign of neurologic damage. Other findings such as pain at the puncture site, post-procedure headache, or minor oozing are common and expected adverse effects that usually resolve with bed rest.
✦ 台美臨床差異
台灣護理師在腰穿後會特別叮嚀病人平躺 4-6 小時，美國則視醫院 Protocol 而定，趨向儘早活動。