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生理適應 · HARD · SATA

護理師照顧一位急性胰臟炎病人,照護計畫應包含哪些項目?(選所有適合的)

A nurse is caring for a client with acute pancreatitis. Which interventions should the nurse include in the plan of care? (Select all that apply.)

  • AMaintain NPO status✓ 正解
    維持禁食狀態
  • BAdminister IV analgesics for pain control✓ 正解
    給予靜脈止痛藥以控制疼痛
  • CEncourage a high-fat diet to increase calories
    鼓勵攝取高脂飲食以增加熱量
  • DMonitor blood glucose levels✓ 正解
    監測血糖水平
  • EPlace the client in a side-lying position with knees flexed✓ 正解
    將病人置於側臥屈膝姿勢
Explanation · 中文詳解

急性胰臟炎(Acute pancreatitis)的護理計畫核心是「讓胰臟休息(Pancreatic rest)」。透過禁止進食(NPO)減少胰液與酵素的分泌,從而緩解胰臟的自我消化與發炎反應。此外,疼痛控制為關鍵,因為劇烈疼痛會引發交感神經反應,加重病情。同時需密切監測內分泌功能(如血糖)與體液平衡,因胰臟發炎可能影響胰島素分泌或導致全身性發炎反應。

The cornerstone of acute pancreatitis care is to rest the pancreas. NPO status reduces enzyme secretion and slows pancreatic auto-digestion and inflammation. Pain control is critical because severe pain stimulates the sympathetic nervous system and worsens the condition. Endocrine function (blood glucose) and fluid balance must be monitored closely, as inflammation may alter insulin secretion and cause systemic inflammatory response. A side-lying position with knees flexed reduces abdominal pressure and relieves pain. High-fat diets (C) stimulate pancreatic enzyme release and are contraindicated.

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