— 生理適應 · MEDIUM · MCQ —
病人行肺葉切除術後置放胸管，護理師應採取下列哪項措施？
A nurse is caring for a client with a chest tube following a lobectomy. Which nursing action is appropriate?
- AStrip the tubing every 2 hours to maintain patency每2小時擠壓管路以維持通暢
- BMaintain the drainage system below the level of the client's chest✓ 正解將引流系統置於病人胸部下方
- CClamp the chest tube if the client is being transported若病人需搬運則夾住胸管
- DMilk the tubing to increase suction pressure拍打管路以增加抽吸壓力
— Explanation · 中文詳解 —
胸管引流瓶必須始終維持在胸腔水平以下，利用重力與負壓促進液體排除，防止倒流引起肺塌陷。夾閉胸管（Clamp）除特殊更換瓶身狀況外應禁止，以免張力性氣胸；擠壓（Strip）管路會產生過大負壓造成肺組織創傷。
The chest tube drainage system must be kept below the level of the client’s chest to utilize gravity and prevent backflow of fluid into the pleural space, which could cause lung collapse. Stripping or milking the tubing creates excessive negative pressure that can damage lung tissue, and clamping the tube risks causing a tension pneumothorax.
✦ 台美臨床差異
台灣胸腔外科病房極為重視胸管護理，且對於管路沖洗之規範相當嚴格，美國則依各醫院 Policy 而異。