護理師照護一位有深部靜脈栓塞（DVT）病史的病人。下列哪項發現暗示可能發生肺栓塞（PE）？
A nurse is caring for a client with a history of DVT. Which findings indicate a potential pulmonary embolism?
- AWarmth and redness in the calf小腿溫熱且發紅
- BIncreased peripheral edema周邊水腫增加
- CMild fever輕微發燒
- DSudden onset of dyspnea and chest pain✓ 正解突發性呼吸困難與胸痛
深部靜脈栓塞（Deep Vein Thrombosis, DVT）是指腿部深層靜脈形成血栓。DVT 的一個最嚴重的潛在併發症是肺栓塞（Pulmonary Embolism, PE），即血栓脫落並移動到肺部動脈，阻塞血流。 選項 D 是最能暗示可能發生 PE 的發現。突發性的呼吸困難（sudden onset of dyspnea）和胸痛（chest pain），尤其是在有 DVT 病史的病人身上，是 PE 的典型症狀。這些症狀源於肺部血管被血栓阻塞，導致肺部灌流不足和缺氧。 選項 A（小腿溫熱、紅腫）是 DVT 的典型局部症狀，表示靜脈發炎和血液回流受阻，但這本身並非 PE 的直接證據，而是 DVT 的表現。 選項 B（周邊水腫增加）可能與 DVT 導致的靜脈回流障礙有關，但同樣是 DVT 的症狀，而非 PE 的特異性表現。若 PE 嚴重，可能導致心臟負荷增加，間接影響體液分佈，但不是 PE 的首要徵兆。 選項 C（輕微發燒）有時可能在 DVT 或 PE 病人身上出現，可能與發炎反應有關，但並非 PE 的典型或優先考慮的診斷線索。 臨床思路（Priority / Assessment / Cardiovascular System）：對於有 DVT 病史的病人，應時刻警惕 PE 的發生。突發的呼吸系統症狀是 PE 的高度警訊，需要立即評估和處理。
Deep Vein Thrombosis (DVT) refers to thrombus formation in the deep veins of the leg. One of the most serious potential complications of DVT is Pulmonary Embolism (PE), in which the thrombus dislodges and travels to the pulmonary arteries, obstructing blood flow. Option D is the finding that most strongly suggests possible PE. Sudden-onset dyspnea and chest pain, especially in a patient with a history of DVT, are classic symptoms of PE. These symptoms result from obstruction of the pulmonary vessels by the thrombus, leading to inadequate pulmonary perfusion and hypoxia. Option A (warmth, redness, and swelling of the calf) is the typical local manifestation of DVT, reflecting venous inflammation and impaired venous return; in itself, however, it is not direct evidence of PE but rather a presentation of DVT. Option B (increased peripheral edema) may be associated with impaired venous return caused by DVT but is still a manifestation of DVT rather than a specific finding of PE. If PE is severe, it may increase cardiac workload and indirectly affect fluid distribution, but this is not a primary sign of PE. Option C (low-grade fever) may sometimes occur in patients with DVT or PE and can be related to the inflammatory response, but it is not a typical or priority diagnostic clue for PE. Clinical reasoning (Priority / Assessment / Cardiovascular System): For a patient with a history of DVT, vigilance for PE must be maintained at all times. Sudden respiratory symptoms are a high-alert warning sign of PE, requiring immediate assessment and intervention.