護理師照護一位使用連續性硬脊膜外止痛輸注的病人，哪項發現需最優先處理？
A nurse is caring for a client with a continuous epidural infusion for pain management. Which finding is the highest priority to address?
- AThe client reports a pruritus on the chest病人主訴胸部搔癢
- BThe client reports a headache when sitting upright病人坐直時主訴頭痛
- CThe client is unable to move their lower extremities病人無法移動下肢
- DThe client has a respiratory rate of 8 breaths per minute✓ 正解病人呼吸速率為每分鐘8次
硬脊膜外麻醉藥物若擴散至高位或過量，會抑制呼吸中樞，導致呼吸抑制（RR < 8-10 次/分），這是致命的緊急狀況。搔癢（Pruritus）是副作用但非急症；下肢無法移動是麻醉的預期效果，但需監測；頭痛可能是硬脊膜穿刺後的腦脊髓液滲漏，需後續處理，但均不如呼吸抑制來得急迫。
If epidural medication spreads too high or is excessive, it can suppress the respiratory center, causing respiratory depression (RR <8-10 breaths/min), which is a life-threatening emergency. Pruritus is a side effect but not an acute emergency; inability to move the lower extremities is an expected effect of anesthesia but requires monitoring; a headache could indicate cerebrospinal fluid leakage after dural puncture and requires follow-up management, but none of these is as urgent as respiratory depression.
美國疼痛專科護理師（Pain Service）介入非常普遍；台灣多由麻醉科醫師與原科醫師共同管理。