— 基本照護與舒適 · MEDIUM · MCQ —
下列哪位病人最容易發生吸入性肺炎？
Which client is at the highest risk for aspiration?
- AAn alert client with a history of hypertension有高血壓病史且意識清楚的病人
- BA client who can ambulate independently能獨立行走的病人
- CA client with an intact swallow reflex吞嚥反射完好的病人
- DA client receiving enteral feedings via nasogastric tube✓ 正解經鼻胃管接受腸內營養餵食的病人
— Explanation · 中文詳解 —
吸入性肺炎（Aspiration pneumonia）的風險與保護性反射（如吞嚥、咳嗽反射）及胃內容物逆流的機率密切相關。鼻胃管（NG tube）會干擾食道下括約肌（LES）的閉合，使胃內容物容易逆流進入食道與呼吸道。對於長期留置管路的病人，維持正確體位（如床頭抬高至少 30-45 度）是預防吸入的首要護理措施。
Clients receiving enteral feedings via a nasogastric tube are at the highest risk for aspiration because the tube interferes with the closure of the lower esophageal sphincter. This impairment increases the likelihood of gastric contents refluxing into the esophagus and being aspirated into the respiratory tract, necessitating strict positioning protocols such as elevating the head of the bed.