— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師教導病人自行皮下注射依諾肝素（enoxaparin）。下列哪些衛教內容正確？（選所有適合的）
A nurse is teaching a client about self-administration of subcutaneous enoxaparin. Which instructions are appropriate? (Select all that apply.)
- AInject the medication into the abdominal fat pad✓ 正解將藥物注入腹部脂肪墊
- BExpel the air bubble from the pre-filled syringe before injection注射前排出預充式注射器中的氣泡
- CDo not rub the injection site after administration✓ 正解注射後勿揉搓注射部位
- DRotate injection sites between the left and right abdomen✓ 正解在左右腹部之間輪替注射部位
- EUse an ice pack on the site immediately after injection to prevent bruising注射後立即在注射部位使用冰敷以預防瘀青
— Explanation · 中文詳解 —
Enoxaparin 的衛教核心在於預防出血與皮下血腫。氣泡是為了確保藥物全部注入，不應排出。揉搓注射部位會增加微血管出血與瘀青風險。腹部注射需避開肚臍周圍，並左右交替部位以防皮下脂肪增生或萎縮。冰敷雖可減緩不適，但非強制常規建議。
Enoxaparin should be injected into the abdominal fat pad, rotating sites between the left and right sides to prevent lipodystrophy. Do not rub the injection site, as this increases the risk of capillary rupture and hematoma. The air bubble in the pre-filled syringe should not be expelled, as it ensures the full dose is delivered.
✦ 台美臨床差異
台灣醫院常規衛教較強調護理師示範，美國則鼓勵病人於出院前在監控下執行操作。