— 基本照護與舒適 · MEDIUM · MCQ —
一位病人剛接受全髖關節置換術。為預防脫位，護理師應在照護計畫中包含什麼措施？
A client is recovering from a total hip arthroplasty. Which action should the nurse include in the plan of care to prevent dislocation?
- AApply a tight dressing over the incision site在切口部位敷上緊繃的紗布
- BMaintain an abduction pillow between the legs✓ 正解在雙腿之間放置外展枕
- CEncourage the client to cross their legs to increase comfort鼓勵病人交叉雙腿以增加舒適感
- DEnsure the hip is flexed beyond 90 degrees while sitting確保坐姿時髖關節屈曲超過 90 度
— Explanation · 中文詳解 —
全髖關節置換術後，預防脫位是核心護理目標。使用外展枕（Abduction pillow）能確保髖關節維持外展狀態，防止內收導致關節脫位。交叉雙腿（C）與彎曲髖關節超過 90 度（D）都是術後禁忌，會對手術處造成極大壓力。加壓包紮（A）主要用於控制出血與腫脹，非防止脫位之核心措施。
An abduction pillow maintains the hip in a neutral, abducted position, which is critical for preventing dislocation after total hip arthroplasty. Actions such as crossing the legs or flexing the hip beyond 90 degrees are contraindicated as they increase the risk of prosthetic displacement.
✦ 台美臨床差異
美國多使用輔具與物理治療師共同監督術後姿勢；台灣常由護理師衛教家屬使用外展枕，且術後衛教較強調禁忌事項。