— 基本照護與舒適 · MEDIUM · MCQ —
護理師評估病人的傷口。下列哪種特徵顯示傷口正在健康癒合？
A nurse is assessing a client's wound. Which characteristic indicates healthy healing tissue?
- AEschar that is black and leathery黑色皮革狀焦痂
- BSlough that is yellow or white黃色或白色腐肉
- CGranulation tissue that is pink or red✓ 正解粉紅色或紅色的肉芽組織
- DPurulent drainage with a foul odor具惡臭的膿性分泌物
— Explanation · 中文詳解 —
粉紅色或紅色的肉芽組織（Granulation tissue）代表血管增生與修復，是癒合的標誌。黑色痂皮（Eschar）代表組織壞死，黃白色的腐肉（Slough）代表發炎或感染，膿性且有臭味的分泌物則強烈暗示細菌感染。
Pink or red granulation tissue represents new vessel growth and repair and is a hallmark of healing. Black eschar represents tissue necrosis, yellow-white slough indicates inflammation or infection, and purulent, malodorous drainage strongly suggests bacterial infection.
✦ 台美臨床差異
美台護理皆使用相同的傷口評估術語，對於傷口癒合程度的判斷基準亦一致。