— 降低風險 · MEDIUM · SATA —
護理師正在評估有吸入性肺炎風險的病人，下列哪些病人在用餐時需要最嚴密的監測？（選所有適合的）
A nurse is identifying clients at risk for aspiration. Which clients should the nurse monitor most closely during mealtime? (Select all that apply.)
- AClient who had a recent stroke with dysphagia✓ 正解近期有中風且吞嚥困難的病人
- BClient receiving mechanical ventilation via tracheostomy✓ 正解透過氣切接受機械通氣的病人
- CClient with Parkinson's disease✓ 正解患有巴金森氏症的病人
- DClient recovering from an uncomplicated appendectomy正從單純性闌尾切除術恢復的病人
- EClient with a decreased level of consciousness✓ 正解意識程度減低的病人
— Explanation · 中文詳解 —
吸入性肺炎（Aspiration Pneumonia）的風險核心在於「吞嚥功能受損」或「氣道保護反射減弱」。中風病人常有吞嚥困難；帕金森氏症影響喉部肌肉協調；氣切病人因聲門保護機制改變及可能併發的食道受壓，易產生吸入；意識不清的病人則喪失咳嗽與吞嚥反射。護理師需在用餐時進行密切觀察，必要時執行吞嚥評估（Swallow Screen）。
Clients at high risk for aspiration include those with dysphagia from recent stroke, Parkinson’s disease affecting swallowing reflexes, decreased level of consciousness impairing gag reflexes, and those with tracheostomies where the airway protection mechanism is bypassed. These conditions compromise the body's ability to protect the airway during oral intake.