護理師在用餐時間協助一位晚期帕金森氏症病人。下列哪項措施最能有效降低吸入性肺炎的風險？
A nurse is assisting a client with advanced Parkinson's disease during mealtime. Which intervention is most appropriate to reduce the risk of aspiration?
- AInstruct the client to tuck their chin toward the chest while swallowing✓ 正解指示病人在吞嚥時將下巴收向胸部
- BAllow the client to lie flat for 30 minutes after eating to rest允許病人在進食後平躺 30 分鐘以休息
- CProvide thin liquids to facilitate faster clearing of the mouth提供稀薄液體以促進更快清除口腔殘留
- DEncourage the client to tilt their head back when swallowing鼓勵病人在吞嚥時將頭部向後仰
帕金森氏症病人常伴隨吞嚥障礙（Dysphagia），預防吸入的關鍵在於姿勢保護。收下巴動作（Chin-tuck maneuver）能讓會厭軟骨更有效地蓋住氣管開口，同時縮小咽部入口，使食物順暢進入食道。選項 D 的仰頭動作會打開呼吸道，極易導致嗆咳；C 選項的清澈流體流速過快，對吞嚥反應遲緩的病人來說最危險，通常需要加入增稠劑（Thickener）；B 選項餐後平躺會導致食物逆流。護理師應採取「坐直 90 度、收下巴、小口餵食、餐後維持坐姿 30 分鐘」的標準流程，確保進食安全。
Clients with Parkinson's disease often have dysphagia, and the key to preventing aspiration is postural protection. The chin-tuck maneuver allows the epiglottis to more effectively cover the airway and narrows the pharyngeal inlet so that food passes smoothly into the esophagus. Option D, tilting the head back, opens the airway and easily provokes coughing and aspiration; option C, thin liquids, flow too quickly and are the most dangerous for clients with delayed swallowing reflexes, who often require a thickening agent; option B, lying flat after meals, promotes reflux. The nurse should follow the standard protocol of 'upright 90 degrees, chin-tuck, small bites, and remain seated for 30 minutes after meals' to ensure safe feeding.
美國 NCLEX 考題常將「收下巴」作為吞嚥護理的標準答案；台灣臨床則更常提到「增稠劑」的使用。護理師在執業時，兩者皆應結合，並需具備對不同濃稠度液體（如 Nectar-thick）的判斷力。