護理師照護一位經尿道攝護腺切除術（TURP）後進行連續膀胱沖洗（CBI）的病人。發現引流液呈現鮮紅色且有濃稠血塊。護理師的首要措施為何？
A nurse is caring for a client with a continuous bladder irrigation (CBI) following a transurethral resection of the prostate (TURP). The nurse notes the drainage has become bright red with thick clots. What is the priority nursing action?
- ANotify the surgeon immediately立即通知外科醫師
- BAdminister an ordered analgesic給予處方止痛藥
- CDiscontinue the irrigation停止沖洗
- DIncrease the rate of the irrigation fluid✓ 正解增加沖洗液流速
TURP 術後出現鮮紅色血尿並伴隨血塊，常見原因是傷口出血阻塞導管。首要護理處置是加快沖洗速度（Titrate the irrigation），藉由增加沖洗液流量來沖刷血塊並避免管路阻塞。若沖洗後引流顏色未改善才需考慮通知醫師或處理其他併發症。不可停用沖洗，否則會導致膀胱內積血引發劇烈疼痛與感染。
The priority nursing action is to increase the rate of the continuous bladder irrigation to flush out clots and prevent catheter obstruction. Bright red drainage with thick clots indicates active bleeding that requires mechanical clearance to avoid bladder distention. Discontinuing irrigation or waiting without intervention could lead to serious complications like clot retention.
美台對 TURP 後沖洗的護理標準皆一致，均強調維持管路通暢以預防血塊堆積導致的膀胱痙攣。