— 降低風險 · MEDIUM · MCQ —
護理師評估一位使用外固定器的病人，哪項發現需要立即通知醫師？
A nurse is performing an assessment on a client with an external fixation device. Which finding requires immediate notification of the surgeon?
- AIncreased pain not relieved by analgesics✓ 正解止痛藥無法緩解的疼痛加劇
- BMinimal redness at the entry point穿刺點處有輕微紅腫
- CCrusting around the pin sites鋼釘周圍有結痂
- DSerous drainage at pin sites鋼釘處有漿液性滲出物
— Explanation · 中文詳解 —
外固定器術後常見輕微滲液與紅腫，但持續且藥物無法緩解的疼痛，常暗示嚴重的併發症如骨髓炎（osteomyelitis）或骨腔壓力增加。漿液性滲出物與輕微結痂通常是傷口修復的正常過程，若無發燒或惡臭，多屬預期範圍，但疼痛加劇是神經血管受損或感染的警訊。
After external fixation, mild drainage and erythema are common, but persistent pain unrelieved by analgesics often suggests serious complications such as osteomyelitis or compartment syndrome. Serous drainage and minor crusting are usually normal healing, but escalating pain warns of neurovascular compromise or infection.
✦ 台美臨床差異
美國護理師對神經血管評估（6Ps）有更強的執法權；台灣多需醫師判斷後再由護理師執行後續監測。