— 基本照護與舒適 · HARD · MCQ —
護理師照顧一位留置鼻胃管的病人。在執行灌食前，確認鼻胃管位置最可靠的方法為何？
A nurse is caring for a client with a nasogastric (NG) tube. What is the most reliable method to confirm placement before initiating a feeding?
- AObtaining an X-ray of the chest and abdomen✓ 正解拍攝胸部與腹部X光
- BAuscultating the epigastrium while injecting air注入空氣時聽診上腹部
- CTesting the pH of the gastric aspirate測試胃液抽出物的pH值
- DChecking the external tube marking檢查外部管路標記
— Explanation · 中文詳解 —
雖然 pH 測試常用，但 X 光影像檢查（Radiographic confirmation）仍是金標準（Gold Standard），特別是首次置入或導管位置存疑時。聽診氣流法已被證實不可靠，因為氣體在腸胃道內的聲音會誤導判斷。
Although pH testing is commonly used, radiographic confirmation remains the gold standard, especially upon initial placement or when tube position is in doubt. The auscultation (air insufflation) method has been shown to be unreliable because air sounds in the gastrointestinal tract can be misleading.
✦ 台美臨床差異
兩地均遵循證實醫療指引，但台灣部分臨床場域對長期待管的病人，仍常見僅以回抽胃內容物或 pH 試紙作為確認方式，X 光多於初次置入時執行。