— 生理適應 · HARD · MCQ —
一位剛從甲狀腺切除術後返回病房的病人，哪項護理措施最關鍵？
Which intervention is essential for a client who has just returned from a thyroidectomy?
- AChange the dressing every 2 hours每 2 小時更換敷料
- BKeep a tracheostomy tray at the bedside✓ 正解在床邊備妥氣切包
- CMaintain the client in a supine position維持病人仰臥姿勢
- DEncourage the client to talk frequently to assess laryngeal nerve鼓勵病人頻繁說話以評估喉返神經
— Explanation · 中文詳解 —
甲狀腺切除術後最大的風險為呼吸道阻塞，可能由出血腫脹或喉頭水腫引起，因此床邊必須備妥氣管切開包以備急需。C 錯誤，應採取半坐臥位減輕頸部張力與水腫；D 錯誤，術後應讓喉部休息，減少說話以降低喉神經損傷風險；A 錯誤，敷料通常不需頻繁更換。
Airway compromise from postoperative hemorrhage or edema is the primary life-threatening risk after a thyroidectomy; therefore, keeping a tracheostomy tray at the bedside is essential for immediate emergency access. Other interventions, such as frequent dressing changes or maintaining a supine position, are incorrect as they do not address the critical airway priority.
✦ 台美臨床差異
美國醫護對於甲狀腺術後氣管切開包的準備有嚴格規範，台灣醫院亦有此標準，但護理師執行頻率需配合醫師指示。