— 降低風險 · EASY · MCQ —
護理師照護一名全髖關節置換術後的病人，下列哪項措施對於降低肺栓塞風險最為優先？
A nurse is caring for a client who is post-operative following a total hip arthroplasty. Which intervention is the priority to reduce the risk of a pulmonary embolism?
- AMaintain the client in a high-Fowler's position維持病人於高福勒氏臥位
- BEncourage deep breathing and coughing exercises鼓勵深呼吸和咳嗽運動
- CApply sequential compression devices as ordered✓ 正解依指示使用順序加壓裝置
- DPerform passive range-of-motion exercises on the operative hip對手術側髖關節執行被動關節活動度運動
— Explanation · 中文詳解 —
全髖關節置換術後，下肢深層靜脈血栓（DVT）形成的風險極高，這是導致肺栓塞（PE）的最常見原因。氣動式加壓器（SCD）能促進血液回流，預防靜脈淤滯，在術後初期是降低血栓栓塞風險的最關鍵物理性預防措施。
Sequential compression devices (SCDs) are the priority intervention because they mechanically promote venous return and reduce venous stasis, which is the primary mechanism for preventing deep vein thrombosis (DVT) and subsequent pulmonary embolism in post-operative hip patients. While deep breathing prevents atelectasis, SCDs specifically target the hemodynamic changes associated with thromboembolism risk.
✦ 台美臨床差異
美國護理站常備有自動化加壓裝置，台灣部分醫院仍仰賴彈性襪，近年來 SCD 使用率已逐漸提升。