護理師照護一位接受全髖關節置換術(後側入路)後的病人。下列哪種姿勢最能有效預防人工關節脫位?
A nurse is caring for a client who is post-operative following a total hip arthroplasty (posterior approach). Which position is most appropriate to prevent dislocation of the prosthesis?
- APlace an abductor pillow between the legs while in bed✓ 正解用肥皂和水洗手
- BKeep the affected leg adducted toward the midline僅用溫水沖洗雙手
- CMaintain the hip in more than 90 degrees of flexion使用葡萄糖酸氯己定 (CHG) 濕巾
- DEncourage the client to cross their legs when sitting in a chair酒精性搓手液
全髖關節置換術(THA)後側入路病人的三大禁忌(Hip Precautions)是:髖關節屈曲超過 90 度、內收(Adduction)以及內旋(Internal Rotation)。為了防止這些危險動作導致人工關節從後方脫出,在床上時應使用「外展枕」(Abductor Pillow)放置於雙腿之間,確保患肢維持在外展(Abduction)姿勢。選項 B(內收)、C(過度屈曲)和 D(交叉雙腿)都是極高風險的脫位動作。護理師必須教育病人使用加高馬桶座、避免低矮沙發,且翻身時必須由兩位護理人員協助,確保兩腿之間始終夾著枕頭,維持髖關節的穩定性。這屬於高級臨床照護知識,涉及外科手術後的特定活動限制。
For a posterior approach total hip arthroplasty, hip precautions include avoiding flexion beyond 90 degrees, adduction, and internal rotation to prevent dislocation. Placing an abductor pillow between the legs maintains the hip in a safe, neutral, or slightly abducted position, thereby reducing the risk of the prosthesis dislocating posteriorly.
美國 NCLEX 非常看重 THA 的禁忌指導。臨床上美國護理師會使用大量輔助工具(如長柄拾物器、長柄鞋拔)來確保病人不違反 90 度原則。台灣臨床對外展枕的使用同樣重視,但在居家衛教時,輔具的推廣程度可能因家庭經濟狀況或衛教資源而異。