個案即將進行大腸鏡檢查。護理師在檢查前衛教中應包含哪項指導？
A client is scheduled for a colonoscopy. Which instruction should the nurse include in the pre-procedure teaching?
- AWear tight-fitting clothes for the procedure穿著合身的衣物進行檢查
- BArrange for someone to drive the client home安排他人開車送個案回家正確答案
- CTake iron supplements the morning of the procedure在檢查當天早上服用鐵劑
- DConsume a high-fiber diet the day before the procedure檢查前一天攝取高纖飲食
- B安排他人開車送個案回家
大腸鏡檢查通常在中度鎮靜（moderate sedation）下進行，鎮靜藥物會影響判斷力與反應時間，病人於檢查後 24 小時內不得自行開車或操作機械，因此必須在排定檢查時就事先安排他人接送返家（選項 B），這是無法於當日補救的安全準備。選項 D 錯誤：檢查前一天應採清流質飲食並「避免」高纖維食物（全穀類、生菜、堅果、帶籽水果），高纖殘渣會滯留腸道而降低腸道準備品質、遮蔽黏膜病灶，甚至導致檢查必須重做。選項 A 錯誤：應穿著寬鬆舒適的衣物以利更衣與檢查。選項 C 錯誤：鐵劑會使腸壁附著黑色黏稠殘留物而嚴重影響觀察視野，一般建議檢查前數日即停用。
- A穿著合身的衣物進行檢查
檢查時需更換醫院專用檢查袍，穿緊身衣服會造成檢查過程及更衣的不便，非正確指導。
- B · 正確答案安排他人開車送個案回家
因檢查過程使用鎮靜藥物，病人反應與判斷力會受損，術後絕對不可自行駕駛，必須由他人陪同離院。
- C在檢查當天早上服用鐵劑
鐵劑（Iron supplements）會導致糞便顏色變深，影響大腸鏡檢查時視野的清晰度，檢查前通常需暫停。
- D檢查前一天攝取高纖飲食
檢查前確實需採取清流質飲食（Clear liquid diet）以清潔腸道，但此為準備流程，非術後安全指導。
在美國，這項要求是法律與保險規定的強制標準（Legal/Safety policy），若病人無陪同者，醫院有權取消手術，護理師需嚴格執行此規範以規避法律責任。實際要求可能受聯邦法、州法、州護理委員會規則與機構政策影響；本題依題幹所示護理原則作答。
English explanation
Option B is correct because colonoscopy is usually performed under moderate sedation, which impairs judgment and reaction time. The client must not drive or operate machinery for 24 hours after the procedure and should arrange in advance for someone to provide transportation home. Option A is incorrect because the client should wear loose, comfortable clothing to facilitate changing and the examination. Option C is incorrect because iron supplements produce black, sticky residue that adheres to the intestinal wall and severely obstructs visualization; they are generally stopped several days before the procedure. Option D is incorrect because the client should consume clear liquids and avoid high-fiber foods the day before the examination. Whole grains, raw vegetables, nuts, and seeded fruits can leave intestinal residue, reduce the quality of bowel preparation, obscure mucosal lesions, and potentially require the procedure to be repeated.
最近修訂：2026-09-30