— 降低風險 · MEDIUM · MCQ —
護理師照護一位進行攝護腺切除術（TURP）並持續膀胱沖洗（CBI）的病人。哪項發現需要立即通知外科醫師？
A nurse is caring for a client with a continuous bladder irrigation (CBI) following a transurethral resection of the prostate (TURP). Which of the following findings would necessitate notifying the surgeon immediately?
- AThe patient reports bladder spasms病人報告膀胱痙攣
- BThe urine output is less than the irrigation input✓ 正解尿液輸出量少於灌洗輸入量
- CThe patient complains of a strong urge to void病人抱怨有強烈的排尿慾望
- DThe urine drainage in the bag is bright red收集袋中的尿液引流液呈鮮紅色
— Explanation · 中文詳解 —
CBI 的目的是防止血塊阻塞。若輸出量小於輸入量，代表引流受阻，膀胱內積液會導致擴張甚至穿孔。Bright red urine 為術後早期常見，痙攣與尿意亦屬常見併發症，但引流不暢是機械性故障，若不及時處理會導致嚴重併發症。
Continuous bladder irrigation (CBI) is used to prevent clot formation and maintain catheter patency. If urine output is less than the irrigation input, it indicates an obstruction that can lead to bladder distension and potential rupture, requiring immediate surgical notification.
✦ 台美臨床差異
美台對 CBI 阻塞的處理均非常謹慎，台灣護理師通常會先執行人工沖洗（manual irrigation）排除血塊後再評估是否聯絡醫師。