— 藥理與非經腸給藥 · EASY · MCQ —
護理師為術後病人皮下注射依諾肝素（Enoxaparin）。下列哪項操作正確？
A nurse is administering a dose of subcutaneous enoxaparin to a postoperative client. Which action is correct?
- AMassage the injection site vigorously after withdrawal拔針後用力按摩注射部位
- BExpel the air bubble in the prefilled syringe before injection注射前排出預充式針筒內的氣泡
- CAdminister the injection into the abdominal subcutaneous tissue✓ 正解將注射劑注入腹部皮下組織
- DAspirate for blood return before injecting the medication注射藥物前抽吸確認是否有血液回流
— Explanation · 中文詳解 —
依諾肝素（低分子量肝素）通常採用預充式針筒，設計上包含一個空氣氣泡，該氣泡旨在確保藥物完全遞送，不應排出。注射時應選擇腹部皮下脂肪層，且注射後不可按摩，以免引發出血或瘀青。此外，抗凝血劑給藥過程不需要抽吸，因為抽吸會增加局部微血管出血風險。
Enoxaparin is administered via subcutaneous injection into the abdominal tissue, which provides consistent absorption for low-molecular-weight heparin. The air bubble in the prefilled syringe should not be expelled, as it ensures the full dose is delivered. Vigorous massage of the site is contraindicated to prevent hematoma formation, and aspiration is unnecessary as it may increase tissue trauma and bleeding risk.
✦ 台美臨床差異
台灣部分臨床常規仍有舊式習慣會抽吸，但目前標準護理教育已與國際同步，強調禁止抽吸與按摩。