護理師照護一位腹部手術後 24 小時的病人。預防深部靜脈栓塞（DVT）最有效的護理措施為何？
A nurse is caring for a client who is 24 hours post-abdominal surgery. What is the most effective nursing action to prevent deep vein thrombosis (DVT)?
- ARestricting oral fluid intake限制口服液體攝取
- BPlacing a pillow under the client's knees在病人膝蓋下放置枕頭
- CMassaging the lower extremities按摩下肢
- DEncouraging early ambulation✓ 正解鼓勵早期下床活動
手術後病人發生 DVT 的主要原因是靜脈血流淤滯。核心概念是透過腓腸肌的收縮來促進下肢靜脈回流，進而預防血栓形成。早期下床活動（Early Ambulation）是被公認為最有效且最經濟的預防措施。選項 B 會壓迫膕窩血管，反而增加 DVT 風險；選項 C 若已有隱性血栓存在，按摩可能導致血栓脫落引發肺栓塞，是禁忌；選項 A 會使血液濃縮，增加血栓風險。臨床護理首重安全與預防，應在病人疼痛受控後儘早協助其離床活動。
The main cause of DVT in postoperative patients is venous stasis. The core concept is to promote venous return in the lower extremities through gastrocnemius contraction, thereby preventing thrombus formation. Early ambulation is recognized as the most effective and economical preventive measure. Option B would compress the vessels in the popliteal fossa and conversely increase DVT risk; Option C, if an occult thrombus is already present, may cause it to dislodge and trigger a pulmonary embolism, and is therefore contraindicated; Option A would concentrate the blood and increase the risk of thrombosis. Clinical nursing emphasizes safety and prevention; once the patient's pain is controlled, the nurse should help the patient out of bed as early as possible.
美國護理高度強調『下床活動』的護理自主性，甚至有專門的術後活動指引；台灣醫院則常配合彈性襪（TED hose）使用，且部分病人因文化習俗較怕術後疼痛而不願活動，需更多衛教溝通。