護理師準備執行右旋糖酐鐵（iron dextran）的肌肉注射。應使用哪種技術？
The nurse is preparing to administer an intramuscular injection of iron dextran. Which technique should the nurse use?
- AMassaging the site after injection注射後按摩注射部位
- BZ-track method✓ 正解Z字軌道技術
- CSubcutaneous injection皮下注射
- DUsing a 1-inch needle for an obese client對肥胖病人使用1英寸針頭
右旋糖酐鐵是一種對皮膚組織具有極強刺激性且會造成永久性染色（Staining）的藥物。為了防止藥物從肌肉層滲漏到皮下組織，護理師必須使用 Z-track（Z 字型軌道）技術。此技術透過拉動皮膚移位後進針，注射完畢拔針後讓組織回位，從而封鎖針刺路徑。注射後絕對不可按摩（A），因為按摩會將藥物推向皮下組織，增加疼痛與染色風險。此藥物嚴禁皮下注射（C）。對於肥胖病人，應選擇足夠長的針頭（D）以確保進入肌肉層，1 英吋通常不足。這是基礎護理技術在藥物給予中的關鍵應用。
Iron dextran is a medication that is highly irritating to skin tissue and causes permanent staining. To prevent the medication from leaking out of the muscle layer into the subcutaneous tissue, the nurse must use the Z-track technique. This technique involves displacing the skin before needle insertion and allowing the tissue to return to its original position after needle withdrawal, thereby sealing the needle path. After injection, massage is absolutely prohibited (A), because massage will push the medication into the subcutaneous tissue and increase pain and staining. Subcutaneous administration of this medication is strictly contraindicated (C). For obese clients, a sufficiently long needle (D) should be selected to ensure the medication reaches the muscle layer; 1 inch is usually inadequate. This is a key application of basic nursing technique in medication administration.
美國 NCLEX 高度重視 Z-track 技術的應用細節。台灣臨床中，由於鐵劑現在多改用靜脈點滴（如 Venofer），肌肉注射的使用率下降，護理師若遇到此類舊型醫囑需特別警惕技術要求。