— 降低風險 · EASY · MCQ —
護理師照護一位全髖關節置換術後的病人。下列何者為減少深部靜脈栓塞（DVT）風險的優先護理措施？
A nurse is caring for a client who is post-operative following a total hip arthroplasty. Which intervention is the priority to reduce the risk of deep vein thrombosis (DVT)?
- AApply a cold compress to the surgical site在手術部位應用冷敷
- BAdminister pain medication as prescribed依醫囑給予止痛藥物
- CRestrict the client to bed rest for 48 hours限制病人卧床休息 48 小時
- DEncourage the client to perform ankle pumps✓ 正解鼓勵病人進行踝關節運動
— Explanation · 中文詳解 —
術後預防 DVT 的核心在於促進下肢靜脈回流。踝關節幫浦運動能藉由腓腸肌的收縮，有效擠壓深部靜脈，防止血液瘀滯。鼓勵病人早期活動與規律運動是臨床最有效的非藥物性預防措施，其餘選項均無法直接改善靜脈血流動力學。
Postoperative DVT prevention centers on promoting venous return from the lower extremities. Ankle pump exercises use contractions of the calf muscles to effectively compress the deep veins and prevent blood stasis. Encouraging early ambulation and regular exercise is the most effective nonpharmacologic prevention in clinical practice; the other options cannot directly improve venous hemodynamics.
✦ 台美臨床差異
美國護理師常依復健醫囑執行早期下床計畫；台灣臨床多由物理治療師評估，且家屬對於術後過早活動的觀念仍較保守。