— 生理適應 · MEDIUM · MCQ —
病人預計進行支氣管鏡檢查。檢查後護理師的優先處置為何？
A client is scheduled for a diagnostic bronchoscopy. Which action is the priority for the nurse following the procedure?
- AEncourage deep breathing鼓勵深呼吸
- BProvide ice chips提供碎冰
- CAuscultate lung sounds聽診肺音
- DAssess for the return of the gag reflex✓ 正解評估嗆咳反射是否恢復
— Explanation · 中文詳解 —
支氣管鏡檢查（Bronchoscopy）通常使用局部麻醉噴霧（如 Lidocaine）噴灑於咽喉，這會暫時抑制嘔吐反射（Gag reflex）。在反射恢復前，若讓病人進食或喝水，會極大增加吸入性肺炎（Aspiration pneumonia）的風險。檢查後的首要安全目標是防止誤吸，必須確認反射完全恢復後才可進食。
Bronchoscopy involves local anesthesia that suppresses the gag reflex, creating a high risk for aspiration if the client eats or drinks before the reflex returns. The priority nursing action is to assess for the return of the gag reflex to ensure airway safety before allowing oral intake.