— 生理適應 · HARD · MCQ —
一位護理師照護疑似肺栓塞的病人，下列哪項徵象最令人擔憂？
A nurse is caring for a client with a suspected pulmonary embolism. Which sign is most concerning?
- ASudden onset of dyspnea突發性呼吸困難
- BHypotension and tachycardia✓ 正解低血壓和心搏過速
- CSharp pleuritic chest pain尖銳的胸膜性胸痛
- DCough with blood-tinged sputum帶有血絲痰液的咳嗽
— Explanation · 中文詳解 —
肺栓塞導致血流阻塞，若出現低血壓與心跳過速，說明已發生血液動力學不穩定（Hemodynamic instability），代表右心室負荷過重並可能隨時心跳停止，為最危急的徵兆。呼吸困難與胸痛是常見症狀，但不及血液動力學崩潰危險。
A pulmonary embolism obstructs blood flow; the appearance of hypotension with tachycardia indicates hemodynamic instability, signifying excessive right ventricular load with the risk of cardiac arrest at any moment, and is therefore the most critical sign. Dyspnea and chest pain are common symptoms but are not as dangerous as hemodynamic collapse.
✦ 台美臨床差異
美國醫院針對肺栓塞有嚴格的快速診斷與抗凝血 protocol，台灣則強調醫師診斷與檢查的迅速介入。