— 生理適應 · MEDIUM · MCQ —
護理師正在照護一位闌尾炎術後恢復的病人。哪項發現提示腹膜炎（peritonitis）的發展？
A nurse is caring for a client recovering from surgery for appendicitis. Which finding suggests the development of peritonitis?
- AAbsence of bowel sounds✓ 正解腸鳴音消失
- BTemperature of 37.5°C (99.5°F)體溫 37.5°C (99.5°F)
- CSlight abdominal distension輕微腹部膨脹
- DPain that is localized to the lower right quadrant疼痛局限於右下象限
— Explanation · 中文詳解 —
腹膜炎是腹腔內層發炎，常由感染引起。其嚴重併發症是腸麻痺（paralytic ileus），導致腸道蠕動停止，聽不到腸鳴音（bowel sounds）。腹脹、全身性疼痛、反彈痛、高燒則是其他表現。闌尾炎術後輕微腹脹、低燒、局部疼痛是常見的，但腸鳴音消失是嚴重問題。
Peritonitis often leads to paralytic ileus, characterized by the absence of bowel sounds due to inflammation-induced cessation of intestinal motility. Although mild fever, slight distension, and localized pain can occur postoperatively, silent abdomen is a distinct indicator of this serious complication requiring immediate attention.
✦ 台美臨床差異
美國的術後照護標準流程會嚴格監測腸鳴音的恢復情況；台灣也重視此點，但病人術後恢復進度可能受個人體質與醫療資源影響。