一位末期肝硬化的 65 歲男性有大量腹水。醫師準備執行床邊腹腔放液穿刺術。下列哪項術前介入是強制必要以防器官損傷？
A 65-year-old male with end-stage cirrhosis has massive ascites. The provider prepares to perform a bedside paracentesis. Which pre-procedure intervention is mandatory to prevent organ injury?
- AHave the client void to empty the bladder immediately before the procedure.✓ 正解讓病人在手術前立即排尿以排空膀胱
- BPosition the client with legs elevated above the head.將病人置於腿部高於頭部的姿勢
- CAdminister prophylactic IV anticoagulants.給藥預防性靜脈抗凝血劑
- DHave the client drink 2 liters of water to expand intra-abdominal pressure.讓病人飲用2公升水以增加腹腔壓力
腹腔放液穿刺術（paracentesis）以盲插粗針穿過腹壁進入腹膜腔。若膀胱滿盈，會脹大上浮入下腹穿刺路徑，造成致命的膀胱穿孔。 選項 A 正確：術前必須排空膀胱以避免膀胱穿孔，是標準流程。 選項 D 錯誤：增加液體會讓膀胱更脹，反增風險。 選項 C 錯誤：抗凝血劑會增加腹膜出血。 選項 B 錯誤：腿高頭低位無生理意義且會增加橫膈膜壓力。
Paracentesis involves blind needle insertion through the abdominal wall into the peritoneal cavity. A full bladder rises into the puncture path and risks fatal bladder perforation. B correct: Voiding to empty the bladder immediately before the procedure prevents bladder perforation. A incorrect: Drinking water enlarges the bladder—increases risk. C incorrect: Anticoagulants increase peritoneal bleeding risk. D incorrect: Trendelenburg-like positioning is physiologically unhelpful and increases diaphragmatic pressure.
「Paracentesis 抽腹水」等於「Empty Bladder 尿尿排空膀胱」。全世界各國消化內科護理師最朗朗上口的口訣。沒叫病人尿完就讓醫生下針，萬一戳破膀胱，護理師與醫生都要吃上嚴重過失責任。