下列哪些護理措施能促進慢性下背痛病人的舒適感?(選所有適合的)
Which of the following nursing interventions promote comfort in a client with chronic back pain? (Select all that apply.)
- AApplying cold packs to the area for 48 hours在該區域敷冰包 48 小時
- BEncouraging regular, light physical activity✓ 正解鼓勵規律的輕度體力活動
- CTeaching the client to lift with the legs, not the back✓ 正解教導病人用腿部而非背部用力搬運物品
- DPromoting a firm mattress for support✓ 正解建議使用堅硬的床墊以提供支撐
- EAdvising prolonged bed rest for recovery建議長期臥床休息以恢復
慢性下背痛(chronic back pain)的管理目標是減輕疼痛、恢復功能並預防復發。這需要綜合性的策略,結合生活方式調整、復健運動與支持性措施。 正確選項分析: B. 鼓勵規律、輕度的體能活動(Encouraging regular, light physical activity):適度的運動,如散步、游泳或特定的伸展運動,有助於強化背部及核心肌群,改善柔軟度,減輕關節僵硬,並促進血液循環,長期而言能有效緩解慢性疼痛。 C. 教導病人用腿部力量提起重物,而非背部(Teaching the client to lift with the legs, not the back):這是正確的生物力學(biomechanics)原則。彎曲膝蓋、利用大腿肌肉力量提起重物,能大幅減少脊椎承受的壓力,預防再次受傷。 D. 鼓勵使用支撐性佳的硬床墊(Promoting a firm mattress for support):堅固、平坦的床墊能提供良好的脊椎支撐,維持脊椎的自然曲線,避免睡覺時脊椎過度彎曲或扭轉,有助於肌肉放鬆和減輕疼痛。 錯誤選項分析: A. 僅使用冷敷 48 小時(Applying cold packs to the area for 48 hours):冷敷(cold packs)主要用於急性期,目的是減輕發炎和腫脹。慢性疼痛的處理,特別是肌肉緊繃或僵硬,通常更適合熱敷(hot packs)或溫熱療法,以促進血液循環、放鬆肌肉。 E. 建議長期臥床休息(Advising prolonged bed rest for recovery):長期臥床會導致肌肉萎縮、骨質流失、關節僵硬,並可能引發憂鬱,反而不利於慢性疼痛的管理和功能恢復。現代醫學強調「活動」而非「臥床」來處理慢性背痛。 臨床思路:處理慢性疼痛時,應優先考慮能促進病人自主管理、恢復功能並提升生活品質的措施(ABC: Activity, Body mechanics, Comfort)。避免可能導致依賴或功能退化的介入(如長期臥床)。
Managing chronic back pain involves promoting mobility and proper body mechanics to maintain function and prevent recurrence. Interventions include encouraging regular light activity to strengthen muscles, teaching proper lifting techniques to reduce spinal strain, and recommending a firm mattress for adequate spinal support. Prolonged bed rest is discouraged as it leads to muscle deconditioning.