— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師為接受全髖關節置換術後的病人皮下注射依諾肝素（Enoxaparin）。下列哪項操作正確？
A nurse is administering a dose of subcutaneous enoxaparin to a client following a total hip arthroplasty. Which action is appropriate?
- AInject the medication into the abdominal wall✓ 正解將藥物注射至腹壁
- BMassage the injection site after removal of the needle拔針後按摩注射部位
- CExpel the air bubble from the prefilled syringe before injection注射前排出預充式針筒內的空氣泡
- DAspirate before injecting the medication注射前進行抽吸
— Explanation · 中文詳解 —
Enoxaparin 預充針筒內的氣泡設計是為了確保完整劑量注入，不應排出。注射應選擇腹壁部位，並採捏皮手法進行。操作中嚴禁抽吸（Aspiration）以防組織受損，且注射後不可按摩，以免引發皮下血腫或瘀青。臨床上應避開肚臍周圍 2 英寸範圍以減少出血風險。
Enoxaparin should be injected into the abdominal wall, and the air bubble in the prefilled syringe should remain to ensure the full dose is delivered and to clear the needle track. Aspiration and massage of the injection site are contraindicated as they increase the risk of bruising and hematoma formation.
✦ 台美臨床差異
台美兩地對 LMWH 注射技術標準一致，但台灣臨床常需醫師口頭確認抗凝血指標後才執行。