護理師照護一位有吸入性肺炎病史的病人。下列哪項措施對於預防復發最有效？
A nurse is caring for a client with a history of aspiration pneumonia. Which intervention is most appropriate to prevent recurrence?
- AOffer liquids with thin consistency提供稀薄液體的飲品
- BEncourage large bites to stimulate swallowing鼓勵大口進食以刺激吞嚥
- CKeep the client supine after meals餐後讓病人保持仰臥姿勢
- DElevate the head of the bed to 30-45 degrees✓ 正解將床頭抬高 30-45 度
吸入性肺炎（Aspiration pneumonia）的預防機制主要建立在「重力」與「擺位」的配合。將床頭抬高 30-45 度能利用重力防止胃內容物反流（Reflux）進入氣管。對於有吸入風險的病人，床頭抬高是標準預防措施（Standard precaution）。除了擺位，護理師還需評估吞嚥功能，並在進食時確保病人處於清醒狀態。若病人吞嚥困難，應會診語言治療師（Speech-Language Pathologist, SLP）進行評估並調整食物稠度，這是預防復發的關鍵臨床思路。
Elevating the head of the bed to 30-45 degrees utilizes gravity to prevent gastric contents from refluxing into the trachea, which is a standard precaution for clients at risk of aspiration. This positioning significantly reduces the likelihood of recurrent aspiration pneumonia compared to supine placement.
在美國臨床，護理師非常依賴 SLP 的專業指導來調整飲食質度（如 IDDSI 標準），且床頭抬高（HOB elevation）是所有高風險病人照護計畫中的強制性指標。