護理師照護一位經尿道攝護腺切除術（TURP）後使用連續膀胱沖洗（CBI）的病人。護理師發現引流停止，且病人主訴嚴重的膀胱痙攣。護理師應首先採取哪項行動？
A nurse is caring for a client with a continuous bladder irrigation (CBI) following a transurethral resection of the prostate (TURP). The nurse notes that the drainage has stopped and the client reports severe bladder spasms. Which action should the nurse take first?
- AIncrease the rate of the irrigation fluid增加沖洗液的速率
- BAdminister an antispasmodic medication給予抗痙攣藥物
- CCheck the urinary catheter tubing for kinks or clots✓ 正解檢查導尿管管路是否有扭曲或血塊阻塞
- DNotify the surgeon immediately立即通知外科醫師
在 TURP 術後使用 CBI 的病人中，引流停止和膀胱痙攣通常意味著管路阻塞（如血塊阻塞）。第一步應當是「評估與排除簡單原因」，即檢查導尿管是否受壓、扭曲（Kinks）或有明顯血塊。如果管路阻塞，液體持續灌入卻無法流出，會導致膀胱過度擴張，引發劇烈疼痛。先解決物理性的阻塞是降低風險的最快方法。給予止痛藥（B）無法解決阻塞問題。增加沖洗速度（A）在阻塞時會惡化疼痛。通知醫師（D）應在護理評估與嘗試排除簡單阻塞無效後進行。
The cessation of drainage accompanied by severe bladder spasms indicates a likely catheter obstruction from kinks or clots. The nurse's first action is to assess and clear the tubing to prevent bladder distention and further complications. Interventions such as increasing irrigation rate or administering medication should only occur after ensuring patency.
在美國，RN 有權限在遇到 CBI 阻塞時依照 protocol 執行手動沖洗（Manual irrigation）以移除血塊。台灣則多由住院醫師執行手動沖洗，但「檢查管路扭曲」仍是兩地護理師共同的首要基本職責。