— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師準備皮下注射肝素（Heparin）。下列哪些措施是正確的？（選所有適合的）
A nurse is preparing to administer heparin subcutaneously. Which of the following actions should the nurse take? (Select all that apply.)
- AAspirate before injecting the medication注射前抽吸
- BInject into the abdomen at least 2 inches away from the umbilicus✓ 正解在距離臍部至少 2 吋處注射於腹部
- CMassage the site vigorously after injection to promote absorption注射後用力按摩注射部位以促進吸收
- DUse a 90-degree angle if there is sufficient adipose tissue✓ 正解若有足夠的皮下脂肪組織，使用 90 度角進針
- ECheck the PTT level prior to every dose每次給藥前檢查 PTT 數值
— Explanation · 中文詳解 —
皮下注射肝素需避開臍周圍 2 英吋區域以減少瘀青。使用 90 度角可確保藥物進入皮下脂肪層。抽回針（aspirate）會增加組織受損與出血風險，且絕對不可按摩注射部位，按摩會導致局部微血管破裂，增加皮下出血機會。PTT 監測通常為靜脈輸注時必要，皮下預防性注射無需每次執行。
The nurse should inject heparin into the abdomen at least 2 inches away from the umbilicus to minimize bruising and use a 90-degree angle if sufficient adipose tissue is present to ensure subcutaneous delivery. Aspiration is contraindicated as it increases the risk of hematoma, and vigorous massage should be avoided to prevent capillary rupture. Routine PTT monitoring is not required for prophylactic subcutaneous doses.
✦ 台美臨床差異
台美臨床皆遵循「不抽回、不按摩」的肝素注射原則，但美國護理師常依據病患 BMI 直接選用針頭長度與角度。