— 降低風險 · HARD · MCQ —
護理師照護一位使用外固定器的病人。下列哪項護理動作是必要的？
A nurse is providing care for a client with an external fixation device. Which nursing action is essential?
- AApply antibiotic ointment to all pin sites daily每天在所有釘道處塗抹抗生素軟膏
- BKeep the device elevated at all times始終將裝置抬高
- CRemove the crusts forming around the pins移除釘子周圍形成的痂皮
- DClean pin sites using aseptic technique✓ 正解使用無菌技術清潔釘道處
— Explanation · 中文詳解 —
外固定器（External Fixation）的照護核心是「預防針位感染」。必須嚴格執行無菌操作（Aseptic technique）清潔針位。抗生素軟膏需視醫囑，非自動添加；痂皮（Crusts）若非感染徵兆，通常保留以保護傷口；抬高雖能消腫，但非護理「必要」動作。
The essential nursing action for a client with an external fixation device is cleaning pin sites using aseptic technique to prevent serious complications such as osteomyelitis. Routine removal of crusts or application of antibiotic ointments is not standard unless specifically indicated by provider orders or signs of infection.
✦ 台美臨床差異
台灣部分地區仍保留「移除痂皮」的傳統護理，但國際最新指引已趨向「保留痂皮」以減少傷口開放風險。