— 生理適應 · HARD · MCQ —
個案突發劇烈腹痛。下列哪項發現最令護理師擔心為潰瘍穿孔？
A client presents with sudden onset of severe abdominal pain. Which finding would be most concerning for a perforated ulcer?
- ABelching打嗝
- BTarry stools黑便
- CReports of burning pain報告有燒灼感的疼痛
- DRigid, board-like abdomen✓ 正解僵硬如木板般的腹部
— Explanation · 中文詳解 —
潰瘍穿孔將腸內容物洩漏至腹膜腔，導致化學性腹膜炎，症狀為「腹部僵硬板狀（Board-like abdomen）」。焦油便（Tarry stools）代表慢性出血；燒灼痛與打嗝（Belching）是消化性潰瘍常見症狀，但不代表穿孔。
Ulcer perforation releases GI contents into the peritoneum, causing chemical peritonitis with a rigid, board-like abdomen. Tarry stools suggest chronic upper GI bleeding; burning pain and belching are typical peptic ulcer symptoms but do not signify perforation.
✦ 台美臨床差異
美國急診護理師在面對此類個案時，會優先準備快速手術準備；台灣同樣重視，但通常在影像確認後才由外科介入。