— 藥理與非經腸給藥 · EASY · MCQ —
護理師為接受全膝關節置換術後的病人施打皮下低分子量肝素。下列哪項操作是正確的？
A nurse is administering a dose of subcutaneous enoxaparin to a client following total knee arthroplasty. Which action is appropriate?
- AMassage the injection site vigorously after administration注射後用力按摩注射部位
- BAspirate for blood return before injecting the medication注射前回抽確認是否有血液回流
- CExpel the air bubble from the prefilled syringe before injection注射前排出預充式針筒內的空氣泡
- DAdminister the injection into the abdominal subcutaneous tissue✓ 正解將注射劑注入腹部皮下組織
— Explanation · 中文詳解 —
Enoxaparin（LMWH）的正確施打部位為腹部皮下組織（臍周區域）。C 項錯誤，預填針筒中的氣泡可幫助藥物完全排入並封住針道，不應排出；A 項錯誤，按摩會增加皮下出血與瘀青風險；B 項錯誤，皮下注射不需回抽以免損傷組織。
Administer enoxaparin into the abdominal subcutaneous tissue, as this site minimizes bruising. Do not massage the injection site, as this increases the risk of hematoma. Aspiration is not required for subcutaneous injections, and the air bubble in the prefilled syringe should be retained to ensure the full dose is delivered.
✦ 台美臨床差異
美國護理師常執行腹部注射；台灣部分單位對 LMWH 注射部位可能有不同規範，但原則上均建議輪替部位。