— 生理適應 · EASY · MCQ —
一位急性胰臟炎病患出現嚴重腹痛，護理師應優先監測哪項評估結果？
A client with acute pancreatitis presents with severe abdominal pain. Which assessment finding is a priority for the nurse to monitor?
- ABlood glucose level血糖值
- BBowel sounds腸蠕動音
- CUrine output尿量
- DRespiratory rate and effort✓ 正解呼吸頻率與努力程度
— Explanation · 中文詳解 —
急性胰臟炎（Acute Pancreatitis）雖然表現為劇烈腹痛，但其最嚴重的致命併發症是急性呼吸窘迫症候群（ARDS）。由於胰臟釋放的發炎介質與酵素會經由血流造成肺部毛細血管通透性增加，導致肺水腫與缺氧。因此，監測呼吸速率與血氧狀況是評估病人生命安全的最優先步驟，這符合 ABC 安全護理原則。
Respiratory complications, particularly acute respiratory distress syndrome (ARDS), are the leading cause of mortality in acute pancreatitis due to inflammatory mediators increasing pulmonary capillary permeability. Therefore, monitoring respiratory rate and effort is the priority assessment to ensure patient safety according to ABC principles.