— 基本照護與舒適 · MEDIUM · MCQ —
一位有吞嚥困難病史的病人，哪項評估結果顯示有吸入性肺炎風險？
Which assessment finding in a client with a history of dysphagia indicates a potential aspiration risk?
- ANormal gag reflex正常的嘔吐反射
- BPocketing food in the cheek✓ 正解食物滯留於頰部
- CClear breath sounds清晰的呼吸音
- DSitting upright during meals進食時保持坐姿
— Explanation · 中文詳解 —
吞嚥困難（Dysphagia）病人發生吸入性肺炎（Aspiration pneumonia）的風險極高。評估發現「口腔側頰殘留食物（Pocketing）」是一個重要的危險指標，顯示病人的舌頭控制與咀嚼功能不佳，食物容易在吞嚥反射時掉入呼吸道。護理師應針對此類風險進行介入，如改變食物質地、採取正確姿勢或進行吞嚥訓練，以確保呼吸道安全。
Clients with dysphagia are at high risk for aspiration pneumonia. Finding 'pocketing of food in the cheek' is an important risk indicator, showing that the client's tongue control and chewing are impaired and that food may fall into the airway during the swallowing reflex. The nurse should intervene by changing food consistency, positioning the client appropriately, or providing swallowing training to ensure airway safety.