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基本照護與舒適 · MEDIUM · MCQ

病人被診斷為「活動力受限」。護理師應優先採取哪項措施以維持關節功能?

A client has a nursing diagnosis of 'Impaired Physical Mobility'. Which intervention should the nurse prioritize to maintain joint function?

  • ARestrict movement to prevent further fatigue
    限制活動以防止進一步疲勞
  • BEncourage the client to remain in one comfortable position
    鼓勵客戶保持一個舒適的姿勢
  • CApply heavy braces to all limbs
    對所有肢體施加重型支架
  • DPerform passive range-of-motion (ROM) exercises✓ 正解
    執行被動關節活動度(ROM)運動
Explanation · 中文詳解

病人被診斷為「活動力受限」(Impaired Physical Mobility),護理目標在於預防併發症(如攣縮、萎縮)。被動關節活動運動(Passive ROM exercises)(D)是維持關節活動度、避免沾黏與攣縮的重要護理介入。鼓勵病人維持單一姿勢(B)會增加壓瘡風險;使用支架(C)應根據醫囑,不可隨意增加;限制運動(A)反而會導致肌肉萎縮。因此,被動 ROM 是維持功能與預防失能的關鍵。

The patient is diagnosed with Impaired Physical Mobility, and the nursing goal is to prevent complications such as contractures and atrophy. Passive range-of-motion (ROM) exercises (D) are an essential nursing intervention to maintain joint mobility and prevent adhesions and contractures. Encouraging the patient to remain in a single position (B) increases the risk of pressure ulcers; the use of braces (C) should follow medical orders and not be arbitrarily added; restricting movement (A) would lead to muscle atrophy. Therefore, passive ROM is key to maintaining function and preventing disability.

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