— 生理適應 · MEDIUM · SATA —
護理師指導一位慢性阻塞性肺病（COPD）病人進行呼吸運動。應包含哪些指導？（選所有適合的）
The nurse is providing teaching to a client with chronic obstructive pulmonary disease (COPD) about breathing exercises. Which instruction should be included? (Select all that apply.)
- AInhale deeply through the mouth經口深層吸氣
- BExhale through pursed lips✓ 正解經圓唇呼氣
- CInhale for 2 seconds and exhale for 4 seconds✓ 正解吸氣 2 秒，呼氣 4 秒
- DUse the diaphragm instead of accessory muscles✓ 正解使用橫膈膜而非輔助呼吸肌
- EPerform rapid, shallow breaths during dyspnea在呼吸困難時進行快速淺層呼吸
— Explanation · 中文詳解 —
COPD 呼吸訓練重點：圓唇呼吸（B）增加氣道壓力防止小氣道塌陷；呼氣時間應為吸氣的兩倍（C）以排出更多 CO2；腹式呼吸（D）利用橫膈減少呼吸負擔。應由鼻吸氣而非口（A），快淺呼吸（E）會加重氣體受困。
Key breathing techniques in COPD: pursed-lip breathing (B) increases airway pressure and prevents small-airway collapse; expiration should be twice as long as inspiration (C) to expel more CO2; diaphragmatic breathing (D) uses the diaphragm to reduce the work of breathing. Air should be inhaled through the nose rather than the mouth (A), and rapid, shallow breathing (E) worsens air trapping.
✦ 台美臨床差異
台美護理在 COPD 衛教內容一致，但美國更強調病人自我管理計畫（Action Plan）的使用。