— 生理適應 · MEDIUM · MCQ —
一位肺葉切除術後置放胸管的病人，哪項發現需要立即通知醫師？
A nurse is caring for a client with a chest tube following a lobectomy. Which finding requires immediate notification to the surgeon?
- A200 mL of bright red blood in the drainage system within 1 hour✓ 正解一小時內引流系統中有 200 mL 鮮紅色血液
- BContinuous bubbling in the water seal chamber水封瓶持續冒泡
- CSubcutaneous emphysema at the insertion site插入部位有皮下氣腫
- DFluctuation of fluid in the water seal tube with respirations水封管內的液體隨呼吸波動
— Explanation · 中文詳解 —
胸管引流物在短時間內出現大量（>100-200 mL/hr）鮮紅色出血，暗示可能有活動性出血（Active hemorrhage），這是術後嚴重的併發症，需立即通知醫師進行評估，可能需要手術止血或輸血。觀察胸管水封瓶（Water seal chamber）的波動與氣泡，雖是監測肺擴張狀況的重點，但相較於大量失血，後者對血流動力學穩定性的威脅更大。
Drainage exceeding 100 to 200 mL of bright red blood within one hour suggests active hemorrhage, which is a serious postoperative complication requiring immediate surgical intervention. While tidaling and minor bubbling are expected findings, significant blood loss poses an immediate threat to hemodynamic stability and must be reported urgently.