— 生理適應 · HARD · MCQ —
一位車禍病人被送至急診，護理師發現有連枷胸（Flail chest）。下列哪項評估最令人擔憂？
A client is brought to the emergency department after a motor vehicle accident. The nurse notes the client has a flail chest. Which assessment is the most concerning?
- ABruising on the chest wall胸壁瘀青
- BHypotension and tachycardia✓ 正解低血壓與心搏過速
- CPain with deep breathing深呼吸時疼痛
- DParadoxical chest wall movement胸壁反常運動
— Explanation · 中文詳解 —
連枷胸的典型表現是反常呼吸（Paradoxical chest wall movement），雖然嚴重，但低血壓與心搏過速暗示可能伴隨有張力性氣胸、肺挫傷或出血性休克。循環衰竭（休克）的徵象比單純的反常呼吸更危及生命，必須優先處理。
While paradoxical chest wall movement is characteristic of flail chest, hypotension and tachycardia are more concerning as they suggest shock from hemorrhage or cardiac tamponade. These signs of circulatory collapse indicate a potentially life-threatening complication that requires immediate intervention beyond managing the chest wall instability alone.
✦ 台美臨床差異
美台對於創傷護理（ATLS/TNCC 準則）原則一致，皆優先處理生命威脅。