— 降低風險 · MEDIUM · SATA —
在為接受腸道營養的病人護理時，哪些介入措施可降低吸入性肺炎的風險？（選所有適合的）
Which of the following nursing interventions help reduce the risk of aspiration in a client receiving enteral feedings? (Select all that apply.)
- AKeep the head of the bed elevated at 30 to 45 degrees✓ 正解保持床頭抬高 30 至 45 度
- BVerify tube placement before each feeding✓ 正解每次餵食前確認管路位置
- CCheck gastric residual volume every 4 hours✓ 正解每 4 小時檢查胃殘留量
- DUse a large-bore feeding tube to prevent clogging使用大管徑餵食管以防止堵塞
- EAdminister feedings as a bolus to save nursing time以推注方式給予餵食以節省護理時間
— Explanation · 中文詳解 —
預防吸入性肺炎的核心是維持氣道保護，包含保持床頭抬高，確保管路位置正確，並定時監測殘餘胃容積（GRV）。大管徑管路（Option D）反而會讓賁門括約肌閉合不全，增加逆流風險。快速灌食（Bolus）容易造成腹脹與溢流，應避免。
Prevention of aspiration pneumonia centers on airway protection, including maintaining head-of-bed elevation, verifying correct tube placement, and periodically monitoring gastric residual volume (GRV). A large-bore feeding tube (Option D) actually impairs closure of the lower esophageal sphincter and increases reflux risk. Rapid bolus feeding can cause abdominal distention and regurgitation and should be avoided.
✦ 台美臨床差異
台灣臨床常見使用大管徑管路以便於給藥與灌食，但在預防吸入性肺炎的觀念上與美方一致。