一位急性胰臟炎病人正接受靜脈輸液且禁食，下列哪項評估發現需要護理師立即關注？

急性胰臟炎（Acute pancreatitis）是一種嚴重的疾病，可能迅速惡化並引發致命的併發症。護理師需要密切監測病人的生理狀況，及時發現並處理危急情況。禁食（NPO）和靜脈輸液是急性胰臟炎的標準治療，旨在讓胰臟休息，減少消化液分泌，並提供水分和電解質。 腹部僵硬、板狀感（Rigid, board-like abdomen）是腹膜炎（Peritonitis）的典型徵兆，這表示腹腔內壁受到嚴重刺激或發炎。在急性胰臟炎的背景下，這可能意味著胰臟炎已引發化學性腹膜炎，或者出現了腸道穿孔、壞死等更嚴重的併發症。腹膜炎會導致嚴重的疼痛、感染擴散，若不及時處理，可能迅速導致敗血症和器官衰竭，危及生命。因此，出現此症狀需要護理師立即採取行動，通知醫師進行緊急評估。 選項 B 是最需要護理師立即關注的發現。板狀腹是腹膜炎的警訊，屬於危急生命的情況。 選項 A 腸鳴音減弱（Hypoactive bowel sounds）在急性胰臟炎中很常見，可能表示腸道麻痺（Ileus），這是疾病的常見表現，但其緊急性不如板狀腹。 選項 C 血清澱粉酶（Serum amylase）升高至 500 U/L（正常值通常低於 100 U/L）證實了胰臟發炎，但這是一個診斷性指標，在急性期數值可能波動，本身不代表當下最緊急的生命威脅。 選項 D 血糖值 140 mg/dL（正常空腹約 70-100 mg/dL）略高，可能與胰臟功能受損有關（胰臟同時分泌胰島素與升糖素），但此數值本身並未達到需要立即緊急處理的危險程度，相較於板狀腹，其危急度較低。 臨床思路：照護急性胰臟炎病人時，需特別警惕可能導致死亡的併發症。板狀腹是腹膜炎的強烈指標，代表腹腔內嚴重狀況，必須優先處理。

Acute pancreatitis is a serious illness that may deteriorate rapidly and lead to fatal complications. The nurse must closely monitor the client's physiological status to promptly identify and address critical situations. NPO (nothing by mouth) status and intravenous fluid therapy are the standard treatments for acute pancreatitis, aimed at resting the pancreas, reducing digestive secretions, and providing hydration and electrolyte support. A rigid, board-like abdomen is a hallmark of peritonitis, indicating severe irritation or inflammation of the peritoneum. In the context of acute pancreatitis, this may signify that pancreatitis has triggered chemical peritonitis or that more serious complications such as bowel perforation or necrosis have occurred. Peritonitis causes severe pain and spread of infection and can rapidly progress to sepsis and organ failure if untreated, posing a life threat. Therefore, this symptom requires the nurse to take immediate action and notify the physician for emergency assessment. Option B is the finding that most requires the nurse's immediate attention. A board-like abdomen is a warning sign of peritonitis and a life-threatening condition. Option A, hypoactive bowel sounds, is common in acute pancreatitis and may indicate paralytic ileus; this is a frequent manifestation of the disease but is less urgent than a board-like abdomen. Option C, serum amylase elevated to 500 U/L (normal value generally below 100 U/L), confirms pancreatic inflammation, but this is a diagnostic marker whose value may fluctuate during the acute phase and does not in itself represent the most urgent life threat at this moment. Option D, a blood glucose of 140 mg/dL (normal fasting approximately 70-100 mg/dL), is slightly elevated and may be related to impaired pancreatic function (the pancreas secretes both insulin and glucagon), but this value alone does not warrant immediate emergency intervention and is less urgent than a board-like abdomen. Clinical reasoning: When caring for a client with acute pancreatitis, the nurse must remain especially vigilant for potentially fatal complications. A board-like abdomen is a strong indicator of peritonitis, reflecting severe intra-abdominal pathology, and must be prioritized.