護理師照護一位新置入周邊置入中心導管（PICC）的病人，下列哪些項目應納入照護計畫？（選所有適合的）
A nurse is caring for a client with a new peripherally inserted central catheter (PICC). Which of the following should be included in the care plan? (Select all that apply.)
- AUse a 10 mL syringe for flushing the catheter✓ 正解使用 10 mL 注射器沖洗導管
- BChange the sterile dressing every 24 hours每 24 小時更換無菌敷料
- CMonitor for redness, swelling, or drainage at the site✓ 正解監測置入部位是否有紅腫或滲出液
- DFlush with heparinized saline after each use✓ 正解每次使用後用肝素鹽水沖洗
- EAssess the length of the external catheter✓ 正解評估外部導管的長度
周邊置入中心導管（PICC）照護的核心在於預防導管相關感染（CRBSI）與機械性併發症。使用 10mL 針筒是為了避免過小針筒產生過大壓力（壓力與活塞面積成反比），導致導管破裂或栓塞噴出。定期評估長度可及早發現導管移位（如向外滑脫），而監測感染徵象（紅腫、滲液）則是預防敗血症的關鍵。此外，封管技術需使用肝素生理鹽水（Heparinized saline）以維持導管通暢。
The core of peripherally inserted central catheter (PICC) care is the prevention of catheter-related bloodstream infection (CRBSI) and mechanical complications. A 10 mL syringe is used because syringes that are too small generate excessive pressure (pressure is inversely related to the area of the plunger), which can rupture the catheter or expel an embolus. Regularly measuring the external length allows early detection of catheter migration (such as outward slippage), while monitoring for signs of infection (redness, swelling, exudate) is critical for preventing sepsis. In addition, catheter locking technique should use heparinized saline to maintain catheter patency.
在美國臨床，PICC 敷料更換頻率多由機構政策（Policy）決定，通常為每 7 天或當敷料受損時更換。台灣部分醫院亦跟進此標準，但仍需依各院感染管制規範為準。