一位病人右小腿出現劇烈局部疼痛與腫脹，且 Homan's 徵象陽性。下列哪項措施最優先？
A client presents with severe localized pain and swelling in the right calf, with a positive Homan's sign. Which action is priority?
- AMaintain bed rest and elevate the limb✓ 正解維持卧床休息並抬高患肢
- BAmbulate the client to prevent further stasis讓病人下床活動以預防進一步血液淤滯
- CMassage the affected area to improve circulation按摩患處以改善循環
- DApply a warm compress to reduce pain敷熱敷以減輕疼痛
此臨床表現高度懷疑為深層靜脈栓塞（DVT）。DVT 處理的首要原則是『嚴禁按摩與下床活動』，因為這些動作會增加栓子脫落並引發肺栓塞（PE）的風險。保持絕對臥床（Bed rest）並抬高患肢（Elevate）有助於減輕腫脹與靜脈壓力。按摩（C）是絕對禁忌。下床（B）會造成栓子移動。熱敷（D）雖然能減輕局部不適，但在急性期會引起血管擴張，若栓子不穩定則有風險，通常醫囑會配合抗凝血治療，且需密切監測呼吸狀態以防 PE。護理師必須立刻通報醫師以安排影像學診斷，在此之前保護病人免於栓塞移動是最重要的處置。
The client's symptoms suggest deep vein thrombosis (DVT), making bed rest and limb elevation the priority to minimize venous pressure and prevent clot dislodgement. Ambulation or massage could cause the thrombus to detach and travel to the lungs, resulting in a life-threatening pulmonary embolism.
美國醫療系統對 DVT 的診斷傾向快速啟動 D-dimer 及靜脈超音波，護理師在發現徵象時即可依 Protocol 啟動止血栓機制；台灣臨床對於 Homan's sign 的依賴度已降低，多直接評估腫脹程度與 Wells Score 判斷。