護理師準備為病人進行右旋糖酐鐵（Iron Dextran）的肌肉注射。應使用哪種技術以防止皮膚染色？
The nurse is preparing to administer an intramuscular (IM) injection of iron dextran. Which technique should the nurse use to prevent staining of the skin?
- AApply a warm compress before the injection注射前施加溫敷
- BMassage the site vigorously after injection注射後用力按摩注射部位
- CAdminister the injection in the deltoid muscle於三角肌進行注射
- DUse the Z-track method for administration✓ 正解採用Z字軌跡法（Z-track method）進行注射
右旋糖酐鐵是一種深色、具刺激性的藥液。若在注射過程中或注射後沿著針孔路徑滲漏到皮下組織，會造成皮膚永久性著色（染色）並引起疼痛。Z-track 方法透過在下針前將皮膚與皮下組織拉向一側，在藥液注入肌肉後放開，使針孔路徑形成鋸齒狀（Z字型），從而密封藥液，防止其回流。A（按摩）會促使藥液滲漏到皮下，應嚴格禁止。C（三角肌）肌肉容量太小，不適合此類高刺激性藥物。D（溫敷）對防止染色無效。這是基礎護理技術在藥物給予中的重要應用。
Iron dextran is a darkly colored, irritating solution. If it leaks back along the needle tract into the subcutaneous tissue during or after injection, it can cause permanent skin staining and pain. The Z-track method involves displacing the skin and subcutaneous tissue laterally before needle insertion and releasing it after the medication has been injected into the muscle, creating a zig-zag pathway that seals the medication and prevents backflow. Massage (B) forces the medication into subcutaneous tissue and must be strictly avoided. The deltoid (C) is too small a muscle mass for this highly irritating drug. A warm compress (A) is ineffective at preventing staining. This question illustrates an important application of fundamental nursing technique in medication administration.
美國護理非常強調 Z-track 用於所有刺激性 IM 藥物；台灣臨床護理師雖然知道此技術，但在某些常規 IM 給藥（如一般止痛藥）中較少落實，唯獨鐵劑注射是兩地皆嚴格要求的。