— 生理適應 · MEDIUM · MCQ —
一位慢性支氣管炎病人出現痰量增加且為膿性痰。何項措施最重要？
A client with a history of chronic bronchitis is experiencing increased sputum production and purulent sputum. Which intervention is most important?
- AEncourage increased fluid intake✓ 正解鼓勵增加液體攝取
- BAdminister an expectorant給藥祛痰劑
- CProvide chest physiotherapy提供胸部物理治療
- DAdminister oxygen at 4 L/min以 4 L/min 給氧
— Explanation · 中文詳解 —
增加水分攝取有助於稀釋痰液，使其更容易咳出。膿性痰表示有感染，雖然需要抗生素治療，但鼓勵病人多喝水是改善痰液清除的重要支持性措施。鎮咳劑（expectorant）效果有限；高流量氧氣對 COPD 病人不安全；胸腔物理治療（chest physiotherapy）可輔助清除痰液，但多喝水是基本且重要的。
Encouraging increased fluid intake is the most important intervention to thin respiratory secretions, facilitating expectoration in clients with chronic bronchitis. While antibiotics may be needed for purulent sputum, hydration is the foundational supportive measure for airway clearance. Expectorants have limited efficacy, and high-flow oxygen requires careful titration in COPD patients.
✦ 台美臨床差異
美國在慢性支氣管炎病人照護中，常使用脈搏震盪胸腔物理治療設備；台灣則較常見傳統的拍痰和姿位引流。