— 降低風險 · MEDIUM · SATA —
護理師照護一位全髖關節置換術後第一天的病人。下列哪些行動可預防術後併發症?(選所有適合的)
A nurse is caring for a client who is post-operative day 1 following a total hip arthroplasty. Which actions should the nurse take to prevent complications? (Select all that apply.)
- AMaintain the hip in abduction using an abductor pillow✓ 正解使用外展枕頭保持髖關節外展
- BEncourage the client to cross their legs while sitting鼓勵病人在坐著時交叉雙腿
- CApply sequential compression devices (SCDs)✓ 正解應用順序加壓裝置(SCDs)
- DAssess distal neurovascular status every 4 hours✓ 正解每4小時評估遠端神經血管狀態
- EAssist the client to flex the hip at 120 degrees協助病人將髖關節彎曲至120度
— Explanation · 中文詳解 —
全髖關節置換術後(THA)的照護核心為防止人工關節脫位及預防靜脈血栓(DVT)。術後需持續維持髖關節外展(Abduction),避免內收或屈曲超過 90 度,以免人工關節頭從髖臼脫出。同時,術後長期臥床增加血栓風險,SCDs 可透過機械性壓力促進下肢靜脈回流。神經血管評估(Neurovascular check)則能早期監測術後是否併發腔室症候群或神經壓迫。
Maintaining hip abduction prevents dislocation, while sequential compression devices reduce the risk of deep vein thrombosis. Regular neurovascular assessments allow for early detection of complications such as nerve compression or impaired circulation.
✦ 台美臨床差異
美國臨床護理對於 THA 術後脫位預防的衛教(Hip Precautions)非常嚴格,通常包含三個「不」:不內收、不彎腰超過 90 度、不內旋。台灣臨床環境因病床與輔具設計,對術後活動限制的執行強度與衛教細節可能與美國有差異。