一位 60 歲男性在支氣管鏡檢與肺腫塊切片後 30 分鐘回到病房。他比手畫腳要求飲水，主訴喉嚨乾痛。護理師首要行動為何？
A 60-year-old male returns to the ward 30 minutes after a bronchoscopy with biopsy of a lung mass. He motions for water, complaining of severe throat dryness. What is the nurse's priority action?
- AKeep the client NPO (nothing by mouth) until the gag reflex has fully returned.✓ 正解在吞嚥反射完全恢復前，讓病人禁食（NPO）
- BPosition the client supine so liquids flow easily down the throat.將病人置於仰臥位，以便液體順利流下喉嚨
- CHave the client hyperventilate while drinking to keep liquid out of the airway.讓病人在飲水時過度換氣，以防止液體進入呼吸道
- DAllow sips of clear juice to soothe the throat.允許喝少量清澈果汁以舒緩喉嚨
支氣管鏡檢前會以強效局部麻醉噴霧噴於咽喉以抑制嘔吐反射；術後雖意識清醒但喉嚨神經仍麻痺。 選項 A 正確：必須保持 NPO 直到護理師親自確認 gag reflex（嘔吐反射）完全恢復才能進食或飲水，否則高度誤吸/嗆咳/吸入性肺炎風險。確認方法：用壓舌板輕觸後咽部，觀察是否引發 gag。 選項 D 錯誤：未確認反射前飲水危險。 選項 B 錯誤：平躺增加吸入風險。 選項 C 錯誤：過度通氣與飲水無關，且會引發呼吸性鹼中毒。
Bronchoscopy uses topical anesthetic spray to suppress the gag reflex; the client may be alert but the gag reflex remains numbed. B correct: Maintain NPO until the nurse personally verifies full return of the gag reflex (touch posterior pharynx with a tongue blade and observe gag). Otherwise, risk of aspiration and aspiration pneumonia. A incorrect: Drinking before reflex returns risks aspiration. C incorrect: Supine increases aspiration risk. D incorrect: Hyperventilation is unrelated and causes respiratory alkalosis.
「術後作嘔反射 (Gag reflex)」的確認。舉凡支氣管鏡 (Bronchoscopy) 或是胃鏡 (EGD)。護理師看到從這種檢查防推回來的病人，第一反應就是用護理車上的壓舌棒去戳他的喉嚨深處看會不會咳，在那之前連一口水都不准給。這是全世界上班第一天的交班護理常識。