— 生理適應 · MEDIUM · MCQ —
針對疑似神經性休克的病人，哪項護理介入是正確的？
Which nursing intervention is appropriate for a client with suspected neurogenic shock?
- AExpect bradycardia✓ 正解預期會出現心搏過緩
- BMonitor for peripheral vasoconstriction監測周邊血管收縮
- CAdminister IV fluids as prescribed依處方給予靜脈輸液
- DPlace the client in Trendelenburg position將病人置於特倫德倫堡氏姿勢
— Explanation · 中文詳解 —
神經性休克（Neurogenic Shock）源於脊髓損傷後交感神經傳導中斷，導致副交感神經占優勢。其典型臨床表徵與其他休克類型不同，最顯著的是低血壓伴隨「心搏過緩（Bradycardia）」。護理重點在於監測血壓與心跳，並注意血管擴張導致的皮膚溫暖乾燥（而非冷濕）。Trendelenburg 姿勢目前已不建議用於休克處理，因為會壓迫橫膈膜妨礙呼吸。
Neurogenic shock results from spinal cord injury disrupting sympathetic outflow, leading to unopposed parasympathetic activity. This causes widespread vasodilation and bradycardia, which is a hallmark sign distinguishing it from other shock types. Therefore, expecting bradycardia is the appropriate nursing intervention.
✦ 台美臨床差異
美國臨床對於神經性休克的處理非常強調「脊椎穩定（Spinal Stabilization）」。若懷疑休克，護理師需確認脊椎固定裝置是否正確，並監測 Bradycardia，這與處理低血容量性休克（通常為 Tachycardia）的邏輯完全不同。