— 降低風險 · HARD · MCQ —
護理師照護一位剛置入周邊中心靜脈導管(PICC)的病人,下列哪項措施對預防併發症至關重要?
A nurse is caring for a client with a new peripherally inserted central catheter (PICC) line. Which nursing action is essential to prevent complications?
- AFlush the line with 5 mL of heparinized saline every 24 hours每24小時以5 mL肝素化生理食鹽水沖洗管路
- BUse a 10 mL syringe for flushing the catheter✓ 正解使用10 mL注射器沖洗導管
- CPerform blood draws from the PICC line for all laboratory tests為所有實驗室檢驗從PICC管路抽取血液
- DChange the sterile dressing every 3 days unless soiled除非敷料髒污,否則每3天更換無菌敷料
— Explanation · 中文詳解 —
PICC 導管管徑較細,若使用小於 10 mL 的針筒會產生過高壓力,可能導致導管破裂或導管尖端彈出。使用 10 mL 以上針筒可產生較低壓力,維持導管完整性。其他選項如更換敷料頻率、抽血原則需依據各院感染管制政策執行,非核心安全操作。
Using a 10 mL syringe is essential when flushing a PICC line because smaller syringes generate excessive pressure that can rupture the narrow catheter lumen. Maintaining proper flushing equipment protects the integrity of the central venous access device.
✦ 台美臨床差異
美台醫院皆強調 10 mL 以上針筒使用,但在執行導管照護細節上,台灣醫院更傾向嚴格限制 PICC 抽血以降低導管相關血流感染(CRBSI)。