— 生理適應 · EASY · MCQ —
護理師照顧一名腿部剛打石膏的病患。哪項發現應立即通報？
A nurse is caring for a client with a new cast on their lower leg. Which finding should the nurse report immediately?
- AMinimal swelling輕微腫脹
- BWarm toes腳趾溫暖
- CAbsence of a distal pulse✓ 正解遠端脈搏消失
- DItching under the cast石膏下搔癢
— Explanation · 中文詳解 —
打石膏後的五 P 症候群（Pain, Pallor, Pulselessness, Paresthesia, Paralysis）是腔室症候群（Compartment Syndrome）的警訊。遠端脈搏消失代表血液循環完全中斷，這是急症，必須立即處理以避免組織壞死。
The 5 P's after casting (Pain, Pallor, Pulselessness, Paresthesia, Paralysis) are warning signs of compartment syndrome. Absence of a distal pulse indicates complete interruption of circulation; this is an emergency that must be addressed immediately to prevent tissue necrosis.
✦ 台美臨床差異
兩地對腔室症候群的警覺性皆極高，美國護理師更傾向於在發現異常時直接通知醫師啟動快速反應小組。