護理師準備協助病人進行腰椎穿刺。哪個姿勢最合適?
A nurse is preparing a client for a lumbar puncture. Which position is most appropriate?
- ASemi-Fowler's position半坐臥位
- BLateral recumbent position with knees drawn to abdomen✓ 正解側臥位並將膝蓋彎曲靠近腹部
- CSupine position with head slightly elevated仰臥位且頭部略微抬高
- DProne position俯臥位
進行腰椎穿刺(lumbar puncture)時,病人的姿勢是影響操作成功率與病人舒適度的重要因素。目標是盡量擴大腰椎椎間隙,使針頭更容易穿入脊髓液空間。最理想的姿勢是側臥位(lateral recumbent position),同時將病人的膝蓋彎曲並盡量靠近腹部,頭部也稍微前屈,呈現所謂的「嬰兒蜷曲姿」(fetal position)。這種姿勢能最大程度地將腰椎的棘突(spinous processes)分開,增加椎間隙的寬度,減少穿刺的困難度與潛在的神經損傷風險。其他姿勢,如俯臥或仰臥,都無法有效達到擴張椎間隙的效果。 臨床思路:此題考量醫療處置的執行與病人安全(safety)。正確的擺位能提高程序成功率並降低併發症風險。此題強調解剖學姿勢對於特定侵入性操作的重要性。
The lateral recumbent position with knees drawn to the abdomen maximizes the separation of the spinous processes, widening the intervertebral spaces for easier needle insertion. This fetal-like posture reduces the risk of nerve damage and facilitates the procedure, whereas supine or prone positions do not adequately expose the lumbar spine.