— 基本照護與舒適 · EASY · MCQ —
一位病人安排了一項需要膀胱脹滿的診斷程序。下列哪項護理介入最合適？
A client is scheduled for a diagnostic procedure requiring a full bladder. Which nursing intervention is most appropriate?
- ARestrict all oral intake until the procedure is completed限制所有口服攝取直至程序完成
- BInsert an indwelling urinary catheter to prevent urination插入留置導尿管以防止排尿
- CAdminister a diuretic to ensure bladder filling給予利尿劑以確保膀胱充盈
- DEncourage the client to drink 32 ounces of fluid 1 hour before the procedure✓ 正解鼓勵病患在程序前1小時飲用32盎司液體
— Explanation · 中文詳解 —
診斷程序需要膀胱脹滿（Full bladder）是為了提供良好的超音波穿透路徑，並將腸道從骨盆腔移開，以獲得清晰的影像。在程序前一小時攝取足夠水分（通常為 32 盎司約 1000 mL）是標準的護理準備，能確保水分被吸收並排入膀胱。護理師必須確保病人理解檢查前的準備要求，並在預定時間點完成水分攝取，以避免檢查延誤或影像清晰度不足。
To ensure the bladder is adequately full for the diagnostic procedure, the nurse should encourage the client to drink approximately 32 ounces of fluid one hour prior to the exam. This volume allows sufficient time for absorption and bladder filling without causing excessive discomfort. Restricting fluids, inserting a catheter, or administering diuretics are inappropriate interventions for this purpose.