— 生理適應 · EASY · MCQ —
護理師照護一位剛打上石膏的病人,哪項評估為優先?
A nurse is caring for a client with a new cast on their leg. Which nursing assessment is priority?
- AThe client's appetite病人的食慾
- BTemperature of the room室溫
- CNeurovascular status of the toes✓ 正解腳趾的神經血管狀況
- DLevel of pain in the hip髖部的疼痛程度
— Explanation · 中文詳解 —
打石膏後最需擔心的是骨筋膜室症候群(Compartment Syndrome)。護理師應定時評估腳趾的神經血管狀況(5P:Pain, Pallor, Pulselessness, Paresthesia, Paralysis),這能及早發現循環受阻的問題。
After applying a cast, the priority assessment is the neurovascular status of the affected extremity to detect early signs of compartment syndrome. Nurses should monitor for the 5 Ps: pain, pallor, pulselessness, paresthesia, and paralysis.
✦ 台美臨床差異
台美護理師對於石膏護理原則一致,均高度重視 neurovascular checks。