NurslixJournal
健康促進與維護 · EASY · SATA

一位社區護理師對出生 2 週的新生兒進行例行性產後居家訪視。在檢查嬰兒房時,護理師觀察到嬰兒正趴睡在一張鋪有厚重絨毛毯子的柔軟床墊上。嬰兒床內還放有兩個大型填充玩具,且內側欄杆周圍緊緊綁著厚實的防護墊。母親正準備在旁邊抽菸。護理師必須立刻提供哪些指示,以大幅降低嬰兒猝死症 (SIDS) 的風險?(多選題)

A community health nurse performs a routine postpartum home visit for a 2-week-old newborn. Upon inspecting the nursery, the nurse observes the infant sleeping in the prone position on a soft mattress covered by a heavy plush blanket. The crib also contains two large stuffed animals, and thick bumper pads are securely tied around the inner rails. The mother is preparing to smoke a cigarette nearby. Which instructions must the nurse immediately provide to drastically reduce the risk of Sudden Infant Death Syndrome (SIDS)? (Select all that apply.)

  • AAlways place the infant entirely on their back (supine) for every sleep.✓ 正解
    每次睡眠時都應讓嬰兒完全採仰臥姿勢。
  • BRemove the plush blanket, stuffed animals, and bumper pads completely from the crib.✓ 正解
    將絨毛毯、填充玩具和防撞墊完全移除出嬰兒床。
  • CEnsure the baby sleeps on a firm mattress rather than a soft, yielding surface.✓ 正解
    確保嬰兒睡在堅硬的床墊上,而非柔軟易凹陷的表面。
  • DMaintain a strictly smoke-free environment around the baby at all times.✓ 正解
    始終確保嬰兒周圍保持嚴格無菸環境。
  • EElevate the head of the crib by 30 degrees using a wedge to prevent reflux choking.
    使用楔形枕將床頭墊高 30 度,以防止逆流嗆咳。
Explanation · 中文詳解

本題測驗兒科健康維護:嬰兒猝死症候群 (SIDS) 的預防。根據美國兒科學會 (AAP) 安全睡眠指引,SIDS 的防護原則為「安全睡眠環境 (Safe Sleep Environment)」。嬰兒每次入睡都應採仰臥 (Supine) 姿勢 (選項 A 正確);趴睡 (Prone) 或側睡會增加口鼻被柔軟物覆蓋導致重新吸入二氧化碳的風險。嬰兒床內應淨空,不可放置毯子、枕頭、防撞墊 (Bumper pads) 或填充玩具,這些物品為主要的窒息與夾困危險源 (選項 B 正確)。床墊必須堅硬 (Firm) 平整 (選項 C 正確),過軟的床墊會讓嬰兒臉部陷入而阻塞呼吸道。環境中的二手菸 (Secondhand smoke) 是 SIDS 已被證實的獨立危險因子,會影響嬰兒的呼吸調節與覺醒反應 (選項 D 正確)。選項 E 錯誤,使用楔形枕將嬰兒床頭墊高並不被建議,因為嬰兒可能會往下滑動,導致下巴貼近胸部而阻塞氣道。

To prevent Sudden Infant Death Syndrome (SIDS), infants should always sleep supine on a firm mattress with a bare crib free of soft bedding, stuffed animals, and bumper pads. Furthermore, maintaining a strictly smoke-free environment is crucial, as secondhand smoke impairs respiratory regulation and increases SIDS risk.

✦ 台美臨床差異

世界衛生組織與台美的兒科學會對於 SIDS 防治規範一致。在台灣,針對「不要用防撞床圍 (Bumper pads)」的宣導非常用力,因為過去傳統文化認為小孩撞到頭很嚴重,卻忽視了缺血性窒息的立刻致死率。

Related · 同分類的其他題目

More from Health Promotion & Maintenance

瀏覽全部 1,479 題 健康促進與維護 →
Jump to another chapter