— 生理適應 · MEDIUM · MCQ —
一位病人左小腿診斷為深層靜脈栓塞（DVT）。下列何項護理措施對預防肺栓塞至關重要？
A client presents with deep vein thrombosis (DVT) in the left calf. Which nursing intervention is essential to prevent a pulmonary embolism?
- AMaintain strict bed rest as prescribed✓ 正解遵照指示維持嚴格臥床休息
- BMassage the calf to improve circulation按摩小腿以促進循環
- CApply a heating pad to the calf在小腿處應用熱敷墊
- DPerform passive range of motion exercises執行被動關節活動範圍運動
— Explanation · 中文詳解 —
深層靜脈栓塞（DVT）的急性期護理核心在於防止血栓脫落，因為一旦血栓脫落隨血流進入肺循環，將引發致命的肺栓塞（PE）。絕對臥床休息（Strict bed rest）可減少患肢肌肉收縮與血流動力學波動，降低血栓剝離機率。按摩與熱敷會增加血管擴張或造成物理性壓迫，導致血栓脫落；而活動患肢則會增加靜脈回流速度，均屬高風險行為。
Maintaining strict bed rest is essential during the acute phase of deep vein thrombosis to minimize muscle movement and reduce the risk of clot dislodgement. Activities such as massage, heat application, or active movement are contraindicated as they may precipitate a pulmonary embolism.
✦ 台美臨床差異
台灣與美國對於 DVT 急性期的處理標準一致，均強調抗凝血治療與初期臥床。但在美國，一旦抗凝血劑（如 Heparin 或 LMWH）達到治療濃度，臨床醫師通常會儘早鼓勵病人下床活動，以降低併發症，而非長期臥床。