護理師協助一位皮膚脆弱且有高壓瘡風險的高齡病人進行清潔護理，下列哪項措施最恰當？
A nurse is assisting an elderly client with personal hygiene. The client has fragile skin and is at high risk for pressure ulcers. Which nursing action is most appropriate?
- AApply powder liberally to skin folds在皮膚摺皺處大量塗抹粉劑
- BUse hot water to improve circulation使用熱水以促進循環
- CBathe the client twice daily每日為病人沐浴兩次
- DPat the skin dry instead of rubbing✓ 正解輕拍皮膚使其乾燥，而非擦拭
高齡病人皮膚脆弱，皮下脂肪較少，血管也較表淺，使其更容易在清潔過程中受損或產生壓瘡。因此，在進行個人衛生護理時，應採取溫和、減少摩擦的方式。使用溫水（而非過熱的水）清潔，並在清潔後輕柔地拍乾皮膚，特別是皮膚皺褶處，可以避免過度乾燥或因摩擦造成的表皮剝離。完全拍乾皮膚能預防濕氣滯留，濕氣會破壞皮膚屏障，增加感染和壓瘡的風險。避免用力搓揉，因為這會對脆弱的皮膚造成機械性損傷。 臨床思路：此題考量基本照護（Basic Care & Comfort）與病人安全（safety），特別是針對高風險族群（高齡、皮膚脆弱）。護理措施的選擇應以預防傷害為優先，減少對病人身體的潛在風險。
Older adults have fragile skin, reduced subcutaneous fat, and more superficial blood vessels, making them more vulnerable to injury and pressure ulcers during cleansing. Therefore, personal hygiene care should be performed gently with minimal friction. Cleansing with warm (not hot) water and gently patting the skin dry afterward, especially in skin folds, avoids excessive dryness or epidermal stripping from friction. Thorough patting dry prevents retained moisture, which damages the skin barrier and increases the risk of infection and pressure ulcers. Vigorous rubbing should be avoided because it can cause mechanical injury to fragile skin. Clinical reasoning: This item addresses Basic Care & Comfort and patient safety, particularly for high-risk groups (older adults with fragile skin). Nursing interventions should prioritize injury prevention and reduce potential physical risks to the client.