— 生理適應 · MEDIUM · MCQ —
一位病患在接受輸血時出現腰痛與畏寒。護理師首要行動為何？
A client is receiving a blood transfusion and develops low back pain and chills. What is the nurse's priority action?
- AStop the transfusion immediately✓ 正解立即停止輸血
- BAdminister an antipyretic給予解熱劑
- CSlow the transfusion rate減緩輸血速率
- DObtain vital signs測量生命徵象
— Explanation · 中文詳解 —
腰痛與畏寒是急性溶血性輸血反應（Acute hemolytic transfusion reaction）的典型徵兆，通常是因為血型不合引起。這是一種危及生命的緊急狀況，可能導致腎衰竭與休克。護理師的第一優先行動是「立即停止輸血」，並維持靜脈管路暢通，隨後通知醫師並測量生命徵象，以利後續急救與處理。
The chest clip should be positioned at the level of the armpits to ensure that force is distributed correctly across the shoulders and chest during a collision. Other options reflect unsafe practices, such as placing toddlers forward-facing too early, using the front seat, or having loose harness straps.