護理師正在照護一位腹膜炎病患。下列哪項臨床表現是此病最典型的特徵？
A nurse is caring for a client with peritonitis. Which clinical finding is most characteristic of this condition?
- AIncreased appetite食慾增加
- BBoard-like, rigid abdomen✓ 正解板狀、僵硬的腹部
- CSoft, non-tender abdomen柔軟、無壓痛的腹部
- DHyperactive bowel sounds腸鳴音亢進
腹膜炎（Peritonitis）是腹膜腔的嚴重感染或發炎，通常由器官穿孔（如闌尾破裂）引起。其最經典且具診斷價值的體徵是「板狀腹」（Board-like rigidity）。這是因為腹膜受刺激引發強烈的肌肉反射性痙攣，使腹部摸起來極度僵硬且伴隨劇烈壓痛與反跳痛。選項 D（腸音過強）通常出現在腸胃炎早期或腸阻塞初期，腹膜炎後期常因麻痺性腸栓塞導致腸音消失。選項 C 和 A 與腹膜炎的臨床圖像完全相反。護理師應密切監測敗血症徵象（如發燒、血壓下降），並讓病患維持禁食，準備接受急診手術或高劑量抗生素治療。
Peritonitis is a severe infection or inflammation of the peritoneal cavity, usually caused by perforation of an organ (such as a ruptured appendix). Its most classic and diagnostically valuable sign is a 'board-like rigidity' of the abdomen. This occurs because peritoneal irritation triggers a strong reflexive muscular spasm, making the abdomen extremely rigid to palpation and accompanied by severe tenderness and rebound tenderness. Option D (hyperactive bowel sounds) is typical of early gastroenteritis or early bowel obstruction; in late peritonitis, bowel sounds often disappear due to paralytic ileus. Options C and A are completely opposite to the clinical picture of peritonitis. The nurse should closely monitor for signs of sepsis (such as fever and decreased blood pressure), keep the client NPO, and prepare for emergent surgery or high-dose antibiotic therapy.
美國 NCLEX 經常考「板狀腹」作為急症優先處理的紅旗；台灣臨床護理則更強調對反跳痛（Rebound tenderness）的描述與術後引流管的觀察，兩者對於腹膜炎作為外科急症的共識是一致的。