— 照護管理 · HARD · SATA —
術後病患主訴劇烈腹痛，哪些評估發現需要立即通知外科醫師？（選所有適合的）
A client reports severe abdominal pain after surgery. Which assessment findings require immediate notification to the surgeon? (Select all that apply.)
- AAbsence of bowel sounds.腸鳴音消失
- BA rigid, board-like abdomen.✓ 正解腹部僵硬如木板
- CHypotension and tachycardia.✓ 正解低血壓和心搏過速
- DReports of incisional discomfort.切口不適的報告
- ESudden increase in wound drainage.✓ 正解傷口引流突然增加
— Explanation · 中文詳解 —
腹部術後出現板樣僵硬（腹膜炎徵象）、低血壓伴隨心跳過速（休克徵象）、傷口大量滲液（裂開或出血）皆為危急情況，需立即聯絡醫師。腸蠕動音暫時消失（選項 A）是術後常見，切口不適（選項 D）則可透過醫囑給予止痛藥處置。
A rigid, board-like abdomen suggests peritonitis or internal hemorrhage, while hypotension and tachycardia indicate potential hypovolemic or septic shock. Sudden increases in wound drainage may signal wound dehiscence or active bleeding. These findings represent critical postoperative complications requiring immediate surgical notification, whereas absent bowel sounds and incisional discomfort are expected postoperative findings.
✦ 台美臨床差異
台灣醫師較習慣護理師透過 SBAR 方式報告，美國則更強調早期預警系統（MEWS）。