一位接受經尿道攝護腺切除術(TURP)的病人正在進行連續膀胱沖洗(CBI)，哪種情況需要立即護理介入？

經尿道攝護腺切除術（Transurethral Resection of the Prostate, TURP）後，常會進行連續膀胱沖洗（Continuous Bladder Irrigation, CBI），目的是利用生理食鹽水沖洗膀胱，預防因手術造成的血塊阻塞尿道，維持尿液順暢排出。 正確答案 C 是最需要立即護理介入的情況。CBI 的核心目標是防止血塊阻塞。若病人的引流量（output）顯著少於沖洗液的輸入量（input），表示尿液引流可能受阻，最常見的原因是血塊堵塞了導尿管。若不及時處理，可能導致膀胱過度膨脹、劇烈疼痛、尿滯留，甚至膀胱破裂。護理師應立即評估導尿管是否扭曲、受壓，並執行沖洗（irrigation）以清除阻塞。 錯誤選項 D（紅色尿液）是 TURP 術後常見現象，表示有少量出血，是預期中的，只要引流順暢即可。錯誤選項 B（膀胱痙攣）雖會引起不適，但通常可透過調整沖洗速率或給予藥物緩解，優先級不如引流阻塞。錯誤選項 A（想排尿的感覺）是因為導尿管刺激膀胱頸所致，也是常見現象，通常在引流順暢下可忍受，優先級也低於引流阻塞。 臨床思路：護理師需持續監測 CBI 的輸入與輸出量，並注意尿液的顏色與質地。一旦發現引流不暢，必須迅速反應，避免嚴重併發症。 安全優先：血塊阻塞是 TURP 術後最嚴重的併發症之一，可能導致急性尿滯留與膀胱損傷，立即處理至關重要。

After transurethral resection of the prostate (TURP), continuous bladder irrigation (CBI) uses normal saline to flush the bladder and prevent clot obstruction, maintaining urinary drainage. Option C is the situation requiring immediate intervention: the goal of CBI is to prevent clot obstruction, and if drainage output is significantly less than irrigation input, urine outflow is likely impeded—most commonly by a clot blocking the catheter. Untreated, this leads to bladder distention, severe pain, urinary retention, and possible bladder rupture. The nurse should immediately assess the catheter for kinks or compression and irrigate to remove the obstruction. Option D (red-tinged urine) is expected post-TURP and indicates minor bleeding as long as drainage is unimpeded. Option B (bladder spasms) is uncomfortable but can usually be managed with adjustments or medication and is lower priority than obstruction. Option A (urge to void) is caused by catheter stimulation of the bladder neck and is common and tolerable when drainage is patent. Clinically, the nurse must continuously monitor CBI input and output and the color and character of urine, responding quickly to any drainage problem to prevent serious complications. Clot obstruction is one of the most severe TURP complications and demands immediate action.

TURP 後的 CBI（連續膀胱沖洗）及其護理重點（如監測輸入輸出量、顏色，以及處理血塊阻塞）在台美兩地醫療實踐中是完全一致的。預防與處理血塊阻塞是護理師的關鍵職責，兩地標準操作流程相同。