— 降低風險 · HARD · MCQ —
護理師照顧一位疑似嗜鉻細胞瘤的病人。下列哪項評估是被禁止的？
A nurse is caring for a client with a suspected pheochromocytoma. Which assessment is contraindicated?
- AAssessing the client's blood pressure評估病人的血壓。
- BChecking the client's blood glucose檢查病人的血糖。
- CMonitoring urine output監測尿液排出量。
- DPalpating the abdomen✓ 正解觸診腹部。
— Explanation · 中文詳解 —
嗜鉻細胞瘤（Pheochromocytoma）是一種源自腎上腺髓質的腫瘤，會陣發性或持續性過量分泌兒茶酚胺（如腎上腺素、正腎上腺素）。腹部觸診可能對腫瘤施加物理壓力，導致兒茶酚胺瞬間大量釋放，引發嚴重的致命性高血壓危象（Hypertensive crisis）、心律不整或腦出血。因此，在確診或排除該疾病前，腹部觸診是絕對禁忌。
Pheochromocytoma is a tumor of the adrenal medulla that secretes excess catecholamines (epinephrine, norepinephrine) episodically or continuously. Palpating the abdomen can mechanically compress the tumor and trigger a massive catecholamine surge, leading to a life-threatening hypertensive crisis, arrhythmias, or cerebral hemorrhage. Therefore abdominal palpation is absolutely contraindicated until the diagnosis is confirmed or excluded.