— 降低風險 · EASY · MCQ —
護理師照護一位剛完成全髖關節置換術的病人。為了預防假體脫位，下列哪種姿勢為維持的最高優先事項？
A nurse is caring for a client who has just undergone a total hip arthroplasty. Which position is the highest priority to maintain to prevent dislocation of the prosthesis?
- AMaintain abduction using an abduction pillow✓ 正解使用外展枕維持外展姿勢
- BEncourage the client to cross their legs while sitting鼓勵病人在坐著時交叉雙腿
- CPerform internal rotation of the affected hip frequently經常對患側髖關節進行內旋轉
- DKeep the head of the bed elevated at 45 degrees將床頭抬高維持在45度
— Explanation · 中文詳解 —
全髖關節置換術後，髖關節脫位的風險最高，透過外展枕（abduction pillow）維持患肢外展狀態，可避免髖關節內收而導致股骨頭脫出假體臼杯，這是術後護理的黃金法則。避免屈曲大於 90 度、內收及內轉是防護的核心。
Maintaining hip abduction with an abduction pillow is the priority intervention to prevent prosthetic dislocation after total hip arthroplasty. This positioning keeps the femoral head securely within the acetabular cup by preventing dangerous adduction and internal rotation movements.
✦ 台美臨床差異
美台臨床對於術後姿勢限制的衛教重點一致，但在台灣術後常會更謹慎使用輔助支架防止翻身。