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基本照護與舒適 · MEDIUM · MCQ

護理師照護一位有尿失禁的老人。哪項措施是最高優先級?

A nurse is caring for an older adult with urinary incontinence. Which intervention is the highest priority?

  • AMaintaining skin integrity✓ 正解
    維持皮膚完整性
  • BApplying an adult diaper
    使用成人紙尿褲
  • CRestricting fluid intake
    限制水分攝取
  • DScheduling toileting every 2 hours
    每 2 小時安排如廁
Explanation · 中文詳解

尿失禁(Urinary incontinence)對老年人而言,最大的風險在於尿液長期接觸皮膚導致的「失禁性皮膚炎(Incontinence-associated dermatitis)」與隨後的壓瘡(Pressure ulcer)。雖然如廁訓練很重要,但護理師的第一優先任務(Priority)永遠是維持皮膚完整性,防止因濕氣與化學刺激導致的皮膚損傷。

For older adults with urinary incontinence, the greatest risk is incontinence-associated dermatitis and subsequent pressure ulcers from prolonged urine contact with the skin. Although toileting training is important, the nurse's first priority is always to maintain skin integrity and prevent moisture- and chemical-related skin breakdown.

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