護理師照護一位接受經尿道前列腺切除術（TURP）並進行持續性膀胱灌洗（CBI）的病人，發現引流管停止流動且病人出現膀胱痙攣。護理師應採取何種優先措施？
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 tubing has stopped flowing and the client reports bladder spasms. What is the priority nursing action?
- AAdminister an antispasmodic medication給予解痙攣藥物
- BIncrease the rate of the irrigation solution增加灌洗液流速
- CNotify the surgeon immediately立即通知醫師
- DIrrigate the catheter with a large syringe using sterile saline✓ 正解使用大注射器以無菌生理食鹽水沖洗導尿管
TURP 術後 CBI 停止引流通常是因為血塊阻塞，若未立即排除會造成膀胱膨脹與劇烈痙攣，進而誘發二次出血。利用無菌生理食鹽水手動沖洗導尿管是清除血塊最迅速的方法，以恢復引流暢通，預防更嚴重的併發症。
The priority action is to manually irrigate the catheter with sterile saline to clear any clots causing the obstruction, as this directly addresses the root cause of the bladder spasms and lack of drainage. Administering medication or increasing the irrigation rate without clearing the blockage is ineffective and potentially harmful.
台灣與美國在處理 CBI 阻塞上均強調護理師手動灌洗技能，但美國護理師依 protocol 執行頻率較高，台灣常需視醫師醫囑是否明確授權。