— 降低風險 · MEDIUM · MCQ —
護理師照護一位糞便嵌塞的病人，首要應執行哪項措施？
A nurse is caring for a client with a fecal impaction. Which intervention should the nurse implement first?
- AEncourage fluid intake鼓勵攝取水分
- BIncrease dietary fiber intake增加膳食纖維攝取量
- CPerform digital disimpaction✓ 正解執行徒手清除糞便嵌塞
- DAdminister an oral laxative給予口服瀉藥
— Explanation · 中文詳解 —
糞便嵌塞（fecal impaction）是指堅硬糞塊卡在直腸，口服緩瀉劑通常無效且會引發劇烈腹痛。首要處理方式是藉由指診將糞塊鬆動或取出（digital disimpaction），隨後再進行軟便處置。高纖與喝水屬預防性措施，對於已卡住的糞塊無即時療效。
Fecal impaction is a hardened stool mass lodged in the rectum; oral laxatives are usually ineffective and can cause severe pain. The first-line treatment is digital disimpaction to break up or remove the mass, followed by softening measures. High-fiber intake and increased fluids are preventive and have no immediate effect on an impacted mass.
✦ 台美臨床差異
美國執行指診移除糞塊需醫師醫囑（指診會刺激迷走神經），台灣亦需醫師評估後由護理師執行。