— 照護管理 · EASY · SATA —
護理師照護一位因髖部骨折而需臥床休息的病人，哪些措施對預防深層靜脈血栓（DVT）是必要的？（選所有適合的）
A nurse is caring for a client with a hip fracture who is on bed rest. Which actions are essential for preventing deep vein thrombosis (DVT)? (Select all that apply.)
- AAdminister prescribed anticoagulant medication✓ 正解給予處方的抗凝血藥物
- BMassage the affected calf firmly once per shift每班用力按摩患側小腿一次
- CEncourage frequent position changes✓ 正解鼓勵頻繁改變姿勢
- DKeep a pillow directly under the knees continuously持續將枕頭直接墊在雙膝下方
- EPerform passive range-of-motion exercises for the affected leg✓ 正解對患肢進行被動關節活動運動
— Explanation · 中文詳解 —
髖部骨折臥床病人的 DVT 預防需兼顧藥物與活動措施，包括依處方給予抗凝血藥物、在安全範圍內頻繁變換姿勢，以及依骨科限制進行被動關節活動。用力按摩小腿可能使既有血栓脫落；持續在膝後墊枕並維持屈曲則可能壓迫靜脈、加重血流滯緩。
Preventing deep vein thrombosis in bedridden clients requires a comprehensive approach addressing Virchow’s triad, including anticoagulants, frequent position changes, and passive range-of-motion exercises. Combining these pharmacological and physical interventions is the most effective strategy to reduce venous stasis and clotting risks.
✦ 台美臨床差異
美國臨床對於骨科手術或長期臥床病人，除藥物外，常會強制要求使用連續性氣壓式腿部加壓器（SCDs）或彈性襪（TED stockings），並嚴格執行預防性抗凝血藥物醫囑，護理師需確認醫囑並落實。