— 降低風險 · MEDIUM · MCQ —
護理師準備為氣切病人抽痰。護理師應採取哪項行動以預防過程中發生缺氧？
A nurse is preparing to suction a client with a tracheostomy. Which action should the nurse take to prevent hypoxia during the procedure?
- AApply suction while inserting the catheter插入導管時施加抽吸
- BLimit the number of suction passes to five in a row將連續抽痰次數限制為五次
- CHyperoxygenate the client with 100% oxygen before suctioning✓ 正解抽痰前以100%氧氣進行過度氧合
- DSuction for at least 30 seconds to clear all secretions抽吸至少30秒以清除所有分泌物
— Explanation · 中文詳解 —
為氣切（tracheostomy）病人抽痰是維持呼吸道通暢的重要護理措施，但操作不當可能導致缺氧（hypoxia）等併發症。預防缺氧是抽痰過程中的核心考量，因為抽痰會暫時移除呼吸道內的空氣，降低肺部的氧氣儲備。 過度氧合（hyperoxygenation）是指在抽痰前，給予病人高濃度（通常為 100%）的氧氣約 30 秒至 1 分鐘。這能增加肺部氧氣儲備，提高血氧飽和度，從而為抽痰過程中可能發生的短暫缺氧提供緩衝，顯著降低缺氧風險。這項措施是確保病人安全，避免因抽痰而導致呼吸窘迫的關鍵步驟。
Hyperoxygenating the client with 100% oxygen before suctioning increases pulmonary oxygen reserves, providing a buffer against hypoxia during the procedure. This intervention is critical because suctioning temporarily removes air from the lungs, and pre-oxygenation helps maintain adequate saturation levels.