— 基本照護與舒適 · EASY · MCQ —
一位病人平躺時出現呼吸困難（端坐呼吸），護理師應採取何項介入措施？
Which of the following interventions should the nurse perform for a client experiencing dyspnea while lying flat?
- AInstruct the client to deep breathe while lying flat指示病人在平躺時深呼吸
- BLower the bed to the lowest position將床降至最低位置
- CProvide the client with an extra blanket提供病人額外毯子
- DRaise the head of the bed to a semi-Fowler's position✓ 正解將床頭抬高至半坐臥姿勢（semi-Fowler's position）
— Explanation · 中文詳解 —
端坐呼吸（Orthopnea）是心衰竭的典型表徵。平躺時腹部臟器壓迫橫膈，導致胸腔容積減少，增加呼吸功。採半坐臥（Semi-Fowler's）姿勢可利用地心引力降低橫膈壓力，改善肺部換氣效率。平躺只會加重病人的缺氧感，不應勉強。
Raising the head of the bed to a semi-Fowler's position utilizes gravity to lower the diaphragm, thereby increasing thoracic volume and improving ventilation. This intervention reduces the work of breathing and alleviates dyspnea, whereas lying flat increases abdominal pressure on the diaphragm and worsens respiratory distress.
✦ 台美臨床差異
美國護理指引強調護理師應依據「舒適度」自主調整姿勢；台灣病房空間較窄，調整床頭角度有時受限於病床類型。