— 照護管理 · HARD · MCQ —
護理師同時照護多位病人。根據 ABC 原則，哪位病人需優先處理？
A nurse is caring for multiple clients. Which client needs to be prioritized based on the ABC framework?
- AClient with a stable stage 2 pressure ulcer患有穩定期第二度壓瘡的病人
- BClient with noisy, stridor-like respirations✓ 正解出現嘈雜、似喘鳴聲呼吸的病人
- CClient requesting pain medication for abdominal discomfort因腹部不適要求止痛藥的病人
- DClient needing help to ambulate to the bathroom需要協助步行至洗手間的病人
— Explanation · 中文詳解 —
ABC 原則指呼吸道（Airway）、呼吸（Breathing）、循環（Circulation）。「喘鳴聲」（Stridor）顯示上呼吸道阻塞，為危及生命的緊急情況，需優先處理以維持氣道暢通。其他項目均非立即威脅生命之問題。
The ABC framework refers to Airway, Breathing, and Circulation. Stridor indicates upper-airway obstruction, a life-threatening emergency that must be addressed first to maintain a patent airway. The other items do not pose immediate life-threatening problems.
✦ 台美臨床差異
台美護理教育均重視 ABC 優先順序，但台灣在繁忙臨床常因過多行政瑣事干擾優先級判斷。