— 降低風險 · EASY · MCQ —
一位接受髖關節置換術後的病人，護理師應採取下列哪項措施以降低血栓栓塞的風險？
A nurse is caring for a client who is post-operative following a hip arthroplasty. Which action by the nurse will best reduce the risk of a thromboembolism?
- AMassage the lower extremities to improve circulation按摩下肢以改善循環
- BPlace a pillow under the knees to prevent contractures在膝蓋下方放置枕頭以防止攣縮
- CEncourage the client to perform active dorsiflexion exercises✓ 正解鼓勵個案進行主動背屈運動
- DKeep the client on strict bed rest for 48 hours讓個案嚴格卧床休息 48 小時
— Explanation · 中文詳解 —
髖關節手術後血栓風險高，主動踝關節背屈運動能透過肌肉幫浦作用促進靜脈回流，有效防止血液鬱積。按摩可能導致既有血栓脫落造成肺栓塞；膝下墊枕會壓迫靜脈降低血流；術後鼓勵早期下床與活動是標準護理原則，非絕對臥床。
After hip arthroplasty, the risk of thromboembolism is high. Active dorsiflexion exercises engage the calf muscle pump and promote venous return, effectively preventing stasis. Massaging the legs may dislodge an existing thrombus and cause pulmonary embolism; placing a pillow under the knees compresses venous flow; strict bed rest for 48 hours contradicts the standard of early ambulation.
✦ 台美臨床差異
台美均強調早期活動，美國護理師常配合醫囑直接引導病人進行復健，台灣則多協同物理治療師協助。