— 基本照護與舒適 · HARD · MCQ —
護理師照顧一位有呼吸困難的末期病人。下列哪項護理措施最能提供舒適？
A nurse is caring for a client with terminal illness who is experiencing dyspnea. What is the most appropriate comfort measure?
- AAdminister high-flow oxygen via non-rebreather mask透過非再呼吸面罩給予高流量氧氣
- BPlace the client in a supine position for maximum relaxation讓病人採取仰臥姿勢以達到最大放鬆
- CUse a fan to create a flow of air across the face✓ 正解使用風扇讓氣流吹拂臉部
- DIncrease the dosage of IV fluid to improve perfusion增加靜脈輸液劑量以改善灌流
— Explanation · 中文詳解 —
末期病人的呼吸困難常屬主觀感受（air hunger），風扇吹拂面部可藉由刺激三叉神經產生涼爽感，有效緩解呼吸困難的主觀不適。高流量氧氣在末期常無效且有侵入性；補液增加循環負荷不利呼吸；平躺會阻礙橫膈下降，加重氣促。
Dyspnea in terminal illness is largely subjective (air hunger). A fan directed across the face stimulates the trigeminal nerve, producing a cooling sensation that effectively reduces the perception of breathlessness. High-flow oxygen is often ineffective and uncomfortable; increasing IV fluids can worsen pulmonary congestion; supine positioning restricts diaphragmatic excursion.
✦ 台美臨床差異
緩和醫療觀念兩地皆已趨於成熟，但在臨床執行上，台灣仍較多醫師會選擇持續給予氧氣，護理介入需更具溝通技巧。