— 基本照護與舒適 · HARD · MCQ —
護理師照護一位術後病人，其自評疼痛指數為 8/10。下列哪項護理措施為優先？
A nurse is caring for a postoperative client who reports a pain level of 8/10. Which nursing action is the priority?
- AEncourage the client to practice deep breathing exercises鼓勵病人練習深呼吸運動
- BDocument the pain level and wait for the next shift記錄疼痛程度並等待下一班護理人員
- CCall the family to provide emotional support聯絡家屬提供情感支持
- DAssess the characteristics of the pain and check the medication orders✓ 正解評估疼痛特徵並檢查用藥指示
— Explanation · 中文詳解 —
處理疼痛首重評估（Assessment），了解疼痛性質、部位與誘發因素，方能精確給予處置或判斷是否需聯絡醫師。評估是護理程序的第一步，不能直接給予鎮痛劑或單純衛教，應先確立疼痛來源是否為術後正常範圍或併發症。
Assessment is the first step of the nursing process and is essential before intervening for severe pain. The nurse must evaluate the pain's characteristics and review medication orders to determine the cause and appropriate treatment, ensuring that the response addresses potential complications rather than just masking symptoms.
✦ 台美臨床差異
美國醫院對疼痛評估標準（VAS/NRS）極為嚴格，護理師需於給藥後即時評估效果；台灣亦有評估，但常淪為記錄性質。