— 降低風險 · EASY · MCQ —
護理師照護一位全髖關節置換術後的病人，為預防深部靜脈栓塞（DVT），應採取何種行動？
A nurse is caring for a client who is post-operative following a total hip arthroplasty. Which action should the nurse take to prevent deep vein thrombosis (DVT)?
- AKeep the knees flexed at a 90-degree angle保持膝蓋屈曲呈九十度角
- BEncourage early ambulation as prescribed✓ 正解依處方鼓勵早期下床活動
- CRestrict fluid intake to prevent edema限制水分攝取以預防水腫
- DMassage the lower extremities to improve circulation按摩下肢以改善循環
— Explanation · 中文詳解 —
術後早期活動可透過肌肉泵浦效應促進下肢靜脈回流，是預防 DVT 最有效的非藥物方式。按摩下肢可能導致已形成的栓塞脫落引發肺栓塞，屬禁忌；膝關節彎曲 90 度會壓迫膕窩血管，增加栓塞風險；限制水分會增加血液黏稠度，不利於循環。
Encouraging early ambulation is the priority action to prevent deep vein thrombosis, as it promotes venous blood flow through the muscle pump effect. Knee flexion restricts venous return, fluid restriction increases clotting risk, and massaging the legs is contraindicated due to the danger of dislodging a thrombus.
✦ 台美臨床差異
台美在預防措施上皆遵循指南，但美國物理治療師介入時間更早，護理師更強調協同早期下床。