一位急性胰臟炎病人正經歷劇痛和噁心。何項為優先護理措施？
A client with acute pancreatitis is experiencing severe pain and nausea. Which is the priority nursing intervention?
- AProvide a low-fat diet提供低脂飲食
- BAdminister opioid analgesics✓ 正解給予鴉片類止痛藥
- CEncourage oral fluid intake鼓勵口服液體攝取
- DMonitor vital signs every 4 hours每 4 小時監測生命徵象
急性胰臟炎（Acute Pancreatitis）的核心病理在於胰臟酵素的自我消化，導致劇烈腹痛。疼痛不僅造成病人極大痛苦，亦會透過神經內分泌反應誘發胰液進一步分泌，加劇發炎反應（Pain-secretion cycle）。根據護理優先順序（Priority Framework），止痛為緩解急性症狀與防止併發症的首要護理介入。其他選項如飲食與監測雖為常規護理的一環，但在急性期皆屬次要。
The core pathology of acute pancreatitis is autodigestion of the pancreas by its own enzymes, leading to severe abdominal pain. Pain not only causes great distress for the client but also triggers neuroendocrine responses that stimulate further pancreatic secretion, worsening inflammation (the pain-secretion cycle). Within the nursing priority framework, analgesia is the priority intervention for relieving acute symptoms and preventing complications. Other options, such as diet and monitoring, are part of routine care but are secondary during the acute phase.
在美國臨床，急性胰臟炎病人通常會根據疼痛程度使用 PCA（病患自控式止痛）。傳統認為 Morphine 會導致 Oddi 括約肌痙攣，但在現代實證醫學中已被證實影響有限，臨床仍優先以有效止痛為目標。