— 照護管理 · MEDIUM · MCQ —
護理師正在收納一位嚴重敗血症合併低血壓的病人，下列哪項措施最能改善組織灌流？
A nurse is admitting a client with severe sepsis and hypotension. Which intervention is MOST critical to improve tissue perfusion?
- AAdminister broad-spectrum antibiotics給予廣效型抗生素
- BAdminister vasopressors給予血管收縮劑
- CMonitor urine output hourly每小時監測尿量
- DInitiate intravenous fluid resuscitation✓ 正解開始靜脈補液復甦
— Explanation · 中文詳解 —
敗血症引起的低血壓，首要處理是快速補充體液（IV fluids），以恢復血管內容積、提升血壓和器官灌流。若僅使用升壓劑（vasopressors）而無足夠體液，效果不佳且有副作用。抗生素和監測尿量是重要步驟，但體液復甦是優先。
In sepsis-induced hypotension, the first management priority is rapid IV fluid resuscitation to restore intravascular volume, raise blood pressure, and improve organ perfusion. Using vasopressors alone without adequate volume replacement is ineffective and carries side effects. Antibiotics and urine output monitoring are important steps, but fluid resuscitation takes priority.
✦ 台美臨床差異
美國的急診與加護部門，對敗血症性休克的早期體液復甦有嚴格的時程要求（黃金一小時）；台灣的醫療機構也採納此原則，但病人量與資源可能影響執行速度。