護理師照護一位有心肌梗塞病史，現出現胸痛的病人。哪項評估發現最令人擔憂？
A nurse is caring for a client with a history of myocardial infarction (MI) who is now experiencing chest pain. Which assessment finding is most concerning?
- APain described as 'pressure'疼痛描述為『壓力感』
- BPain accompanied by diaphoresis and nausea疼痛伴隨盜汗和噁心
- CPain radiating to the left arm疼痛放射至左臂
- DPain unrelieved by rest✓ 正解休息後疼痛未緩解
心肌梗塞（Myocardial Infarction, MI）病人出現胸痛，護理優先級在於區分是否為急性冠心症（Acute Coronary Syndrome, ACS）復發。休息後未緩解的胸痛（Pain unrelieved by rest）是極具臨床意義的警訊，代表心肌缺氧未因氧氣需求下降而改善，可能是急性心肌梗塞或不穩定型心絞痛（Unstable Angina）進展，必須立即通報醫師並啟動緊急護理程序。
Chest pain that is unrelieved by rest is the most concerning finding because it suggests severe ischemia or an evolving myocardial infarction rather than stable angina. Unlike typical angina, which resolves with rest or nitroglycerin, persistent pain indicates ongoing myocardial damage requiring immediate medical intervention.
在美國臨床，此類病人通常會依據醫院的 Chest Pain Protocol 立即執行 12-lead ECG，並預備給予 Nitroglycerin 與 Aspirin。台灣醫療環境類似，但美國護理師在執行此類 Protocol 時，依據 Standing Order 的授權範圍通常更明確且廣泛。