— 藥理與非經腸給藥 · EASY · MCQ —
護理師正為深部靜脈栓塞病人注射皮下肝素，下列哪項處置是正確的？
A nurse is administering a dose of subcutaneous heparin to a client with a deep vein thrombosis. Which action is appropriate?
- AMassage the injection site vigorously after administration注射後用力按摩注射部位
- BInject the medication into the abdominal fat pad✓ 正解將藥物注入腹部脂肪墊
- CUse a 1-inch needle to ensure intramuscular delivery使用 1 吋針頭以確保肌肉注射
- DAspirate prior to injecting the medication注射前進行抽回血
— Explanation · 中文詳解 —
皮下肝素注射應選擇腹部脂肪堆積處，避開肚臍周圍 2 英吋。不需抽回血以免造成皮下微血管破裂與淤青。按摩注射部位會刺激血管導致出血與淤青，應避免。肝素為皮下注射藥物，使用 1/2 到 5/8 英吋針頭，不可肌肉注射。
Subcutaneous heparin should be injected into the abdominal fat pad, avoiding the area within two inches of the umbilicus, to ensure consistent absorption. Aspiration is contraindicated as it increases the risk of hematoma formation, and vigorous massage can cause tissue trauma and bleeding. Heparin is administered subcutaneously, not intramuscularly, to prevent necrosis and excessive bleeding.
✦ 台美臨床差異
美台臨床皆嚴禁按摩與抽回血，但台灣部分單位對部位選擇偏好固定於手臂外側或大腿，美國則多強調腹部。