— 生理適應 · EASY · MCQ —
一位急性胰臟炎病人禁食並接受靜脈輸液，下列哪項評估發現暗示潛在併發症？
A client with acute pancreatitis is NPO and receiving IV fluids. Which assessment finding indicates a potential complication?
- ARigid, board-like abdomen✓ 正解腹部僵硬如木板
- BBlood glucose of 140 mg/dL血糖 140 mg/dL
- CSerum amylase level of 400 U/L血清澱粉酶濃度 400 U/L
- DHypoactive bowel sounds腸鳴音減弱
— Explanation · 中文詳解 —
急性胰臟炎併發腹膜炎是致命的，腹部僵硬（Board-like abdomen）是腹膜刺激症狀，暗示穿孔或嚴重的發炎擴散，需立即處置。腸蠕動減慢為常見症狀；澱粉酶高為疾病本身表現；輕微高血糖則與壓力性胰島素分泌抑制有關。
Peritonitis complicating acute pancreatitis is life-threatening, and a rigid, board-like abdomen is a sign of peritoneal irritation suggesting perforation or severe spread of inflammation, requiring immediate intervention. Hypoactive bowel sounds are a common symptom; elevated amylase is an expected manifestation of the disease itself; and mild hyperglycemia is related to stress-induced suppression of insulin secretion.
✦ 台美臨床差異
台美臨床對於急性腹痛之評估均採相似標準，惟美國護理師對腹部觸診之敏銳度訓練更為強調。