— 降低風險 · EASY · MCQ —
護理師照護一位腹部手術後 24 小時的病人，下列哪項措施對於降低深部靜脈栓塞 (DVT) 風險最優先？
A nurse is caring for a client who is 24 hours post-operative after an abdominal surgery. Which action is the priority to reduce the risk of deep vein thrombosis (DVT)?
- AEncourage early and frequent ambulation✓ 正解鼓勵早期且頻繁下床活動
- BAdminister prophylactic subcutaneous heparin給予預防性皮下注射肝素
- CPerform passive range of motion exercises執行被動關節活動範圍運動
- DApply sequential compression devices (SCDs)使用間歇性氣壓加壓裝置 (SCDs)
— Explanation · 中文詳解 —
術後深部靜脈栓塞（DVT）的預防核心在於預防血液淤滯（Venous stasis）。早期下床活動（Early ambulation）利用腿部肌肉的收縮（肌肉幫浦作用）促進靜脈血液回流，是預防 DVT 最有效且經濟的非藥物介入手段。雖然 SCDs 與肝素也很重要，但在病人狀況許可下，活動是生理性的預防方式，應列為優先。
Early and frequent ambulation is the priority intervention to reduce deep vein thrombosis risk because it utilizes the skeletal muscle pump to effectively prevent venous stasis. While pharmacological prophylaxis and mechanical devices are useful, active movement is the most physiologic and effective preventive measure when the client is able to walk.