— 降低風險 · EASY · MCQ —
護理師照護一位剛完成全髖關節置換術的病人。下列哪項護理措施對於預防深部靜脈栓塞 (DVT) 最有效？
A nurse is caring for a client who has just undergone a total hip arthroplasty. Which nursing action is most effective in preventing deep vein thrombosis (DVT)?
- AEncouraging early and frequent ambulation✓ 正解鼓勵早期且頻繁的下床活動
- BMonitoring the neurovascular status every 4 hours每 4 小時監測神經血管狀態
- CMaintaining the affected leg in a neutral position使患肢保持中立位置
- DAdministering prophylactic antibiotics給予預防性抗生素
— Explanation · 中文詳解 —
髖關節置換術後，血液滯留是造成 DVT 的主因。儘早離床活動能促進靜脈血液回流，降低血液淤積風險，是預防栓塞的金標準。維持中立位是預防脫臼，抗生素是預防感染，神經血管評估則是監測併發症而非預防血栓，故皆非最佳解答。
Early and frequent ambulation is the most effective intervention for preventing deep vein thrombosis because it promotes venous return and reduces blood stasis, which is a primary cause of clot formation after hip arthroplasty. While monitoring and positioning are important, they do not actively prevent the physiological process of thrombus development like movement does.
✦ 台美臨床差異
美台兩地在術後復健期程上趨於一致，皆強調 ERAS（術後加速康復）照護路徑，鼓勵術後 24 小時內離床。