— 基本照護與舒適 · HARD · SATA —
護理師照護一位放置鼻胃管（NG）的病人。為確保安全，應採取哪些行動？（選所有適合的）
A nurse is caring for a client with a nasogastric (NG) tube. Which actions should the nurse take to ensure safety? (Select all that apply.)
- AVerify tube placement via X-ray before initial use✓ 正解初次使用前透過 X 光確認管路位置
- BCheck gastric residual volume before each feeding✓ 正解每次餵食前檢查胃殘留量
- CElevate the head of the bed to at least 30-45 degrees✓ 正解將床頭抬高至少 30-45 度
- DFlush the tube with water after each medication administration✓ 正解每次給藥後以清水沖洗管路
- EIrrigate the tube with soda to clear obstructions以汽水沖洗管路以清除阻塞
— Explanation · 中文詳解 —
鼻胃管護理重點在於確認位置、預防吸入與避免堵塞。X 光（A）是確認位置的金標準；殘餘量監測（B）防止胃脹滿；半坐臥（C）防嗆咳；沖洗（D）防阻塞。E 選項錯誤，使用可樂等酸性飲料容易造成管路材質損壞或結塊，應使用無菌水。
Ensuring nasogastric tube safety requires verifying placement via X-ray, checking gastric residuals before feeding, elevating the head of the bed to prevent aspiration, and flushing with water after medications to prevent clogging. Using soda for irrigation is contraindicated as it may damage the tube or cause coagulation, whereas sterile water is the appropriate flush solution.
✦ 台美臨床差異
台灣臨床偶有使用汽水沖管的習慣，但多數教學醫院已明令禁止，改採溫水沖洗。