一位病人有糞石嵌塞（Fecal impaction）。護理師的優先介入為何？
A nurse is caring for a client with a fecal impaction. What is the priority intervention?
- AInstructing the client to push harder指示病人用力排便
- BAdministering a high-volume enema給予大量灌腸
- CDigital removal of the impaction✓ 正解手指清除糞石
- DIncreasing fiber intake immediately立即增加膳食纖維攝取
糞石嵌塞（Fecal impaction）是指堅硬的糞便塊卡在直腸內，導致患者嚴重便秘。此時，腸道蠕動通常已無法排出糞便，灌腸液往往會從糞石旁滲漏出來（Overflow diarrhea），無法達到清潔效果。護理師在取得醫師醫囑後，應進行人工移除（Digital removal），這屬於侵入性護理技術，需小心操作以避免刺激迷走神經（Vagus nerve）引發心搏過緩（Bradycardia）。增加纖維或用力排便對當下的物理阻塞無效，且用力排便可能導致心血管事件。
Intravenous potassium chloride is highly irritating to veins and must be diluted in at least 100 mL of normal saline to minimize the risk of phlebitis and tissue necrosis. IV push administration is strictly contraindicated due to the potential for lethal cardiac arrest, and rapid infusion rates can cause hyperkalemia. While monitoring urine output is important, ensuring correct dilution is the primary safety step during medication preparation.