— 藥理與非經腸給藥 · EASY · MCQ —
護理師為病人執行皮下注射肝素，下列哪項操作是適當的？
A nurse is administering subcutaneous heparin to a client. Which action is appropriate during the administration?
- AInject into the abdominal fat avoiding the umbilicus✓ 正解注射至腹部脂肪層，避開肚臍
- BMassage the site vigorously after injection注射後用力按摩注射部位
- CUse a large-gauge needle to prevent bruising使用大口徑針頭以預防瘀青
- DAspirate before injecting the medication注射前進行回抽
— Explanation · 中文詳解 —
皮下注射肝素（Heparin）的核心原則在於避免組織損傷與出血風險。肝素具有抗凝血特性，注射部位的微血管若受損，極易形成瘀青（Bruising）或血腫。因此，選擇腹部皮下脂肪層並避開肚臍周圍（至少 2 英吋）是為了確保藥物穩定吸收，並減少對腹壁血管的刺激。注射後嚴禁按摩，以免導致藥物擴散過快或造成局部出血。
Subcutaneous heparin should be injected into the abdominal fat, maintaining a distance of at least two inches from the umbilicus to ensure consistent absorption and minimize irritation. Vigorous massage of the site is contraindicated as it increases the risk of bruising and tissue damage due to the medication's anticoagulant properties.
✦ 台美臨床差異
在美國臨床實務中，肝素皮下注射後嚴禁按摩已是標準護理指引（Standard of Care），且注射前不回抽的原則在所有皮下注射皆適用，與台灣臨床教學內容一致。