# 一位使用經皮芬太尼貼片的個案計劃將熱敷墊直接放在貼片上以緩解背痛。護理師應提供哪項指導？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=498090&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位使用經皮芬太尼貼片的個案計劃將熱敷墊直接放在貼片上以緩解背痛。護理師應提供哪項指導？

## 選項

1. 在對該區域加熱前，用彈性繃帶覆蓋貼片
2. 避免在貼片部位直接加熱，並報告未受控制的疼痛 **✔ 正確答案**
3. 加熱時移除貼片，之後再重新貼上同一片貼片
4. 使用最低溫設定，並在治療期間每小時檢查皮膚

**正確答案: 2**

## 解析

外部熱源會增加經皮系統中芬太尼的吸收，提高危及生命的呼吸抑制或過量風險。個案應避免在貼片部位直接加熱，若疼痛未受控制應聯繫處方醫師。

## 深入解析

快速解答
不要在芬太尼貼片上或附近使用熱敷墊。熱能會增加藥物釋放，造成過量風險。

為什麼這是正確的
芬太尼貼片會隨時間透過皮膚釋放藥物。直接外部熱源會增加皮膚血流和藥物吸收，因此原本應緩慢進入的劑量可能過快進入血液，抑制呼吸。

簡單比喻或心智圖像
貼片就像一個緩慢釋放的閘門，外部熱源會迫使閘門開得更大。這個比喻說明了吸收加快，但無法預測確切劑量，也不能取代對發燒、鎮靜和呼吸狀態的評估。

記憶掛鉤
芬太尼貼片加上熱源，等於吸收加快、更鎮靜、更大的呼吸危險。

NCLEX 決策規則
對於經皮芬太尼，應選擇避免使用熱敷墊、電毯、熱水浴缸和其他直接熱源。未受控制的疼痛需要重新評估，而非試圖加速貼片吸收。

為什麼其他選項是錯的
繃帶無法阻擋熱傳導。移除並重複使用貼片會導致劑量不穩定，而低溫設定仍會產生可避免的吸收風險。參考文獻

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]FDA: DURAGESIC Prescribing InformationU.S. Food and Drug Administration

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