一位病人 30 分鐘前剛完成經皮肝臟切片檢查 (Liver Biopsy)，護理師應協助病人採取哪種臥位？
A nurse is caring for a client who underwent a percutaneous liver biopsy 30 minutes ago. In which position should the nurse place the client?
- AHigh-Fowler's position to promote lung expansion高福勒氏臥位以促進肺部擴張
- BLeft side-lying with a pillow under the abdomen左側臥位，腹部下方墊枕頭
- CRight side-lying with a small pillow or towel roll under the puncture site✓ 正解右側臥位，穿刺點下方墊小枕頭或毛巾捲
- DSupine with the head of the bed elevated 45 degrees仰臥位，床頭抬高 45 度
這題的核心考點在於「侵入性檢查後的併發症預防」。肝臟是一個血管極為豐富的器官，經皮肝臟切片最大的風險就是檢查後的出血（Hemorrhage）。為了降低出血風險，護理師必須利用物理壓迫原理。將病人安置於「右側臥位」（Right side-lying），並在穿刺部位下方墊一個小枕頭或捲起的毛巾，可以藉由病人自身的體重對肝臟穿刺點產生持續性的壓力，達到加壓止血的效果。臨床上通常要求病人在切片後維持此姿勢至少 2 到 4 小時。選項 B（左側臥）完全無法提供壓迫；選項 A 與 D（高坐臥或半坐臥）則會增加腹壓或改變重力方向，不利於止血。護理師必須理解解剖位置（肝臟位於右腹部）與止血機轉，才能做出正確的擺位判斷，這是減少風險潛力（Reduction of Risk Potential）的標準護理措施。
The core concept is preventing complications after invasive procedures. The liver is highly vascular, and the greatest risk after percutaneous liver biopsy is hemorrhage. To reduce bleeding risk, the nurse uses physical pressure principles. Positioning the client right side-lying with a small pillow or towel roll under the puncture site uses the client's body weight to apply sustained pressure to the biopsy site, achieving tamponade. Clinically, this position is maintained for at least 2-4 hours post-biopsy. A (left side-lying) provides no compression; A and D (high-Fowler's or supine with head elevation) increase abdominal pressure or change gravity, neither favorable for hemostasis. The nurse must understand anatomic location (liver on the right) and hemostasis mechanism to make correct positioning decisions; this is standard care for Reduction of Risk Potential.
美國 NCLEX 考題非常強調「側臥加壓 2-4 小時」的具體時數與物理機轉；台灣臨床實務中，除了要求病人側臥外，護理師常會搭配使用 1-2 公斤的小砂袋 (Sandbag) 直接加壓於傷口處，這是美國臨床較少見的輔助工具應用差異。