— 基本照護與舒適 · MEDIUM · MCQ —
一位失智症病人夜間遊走（Wandering），下列何項介入措施最適合？
A nurse is caring for a client with a diagnosis of dementia who is wandering at night. Which intervention is most appropriate?
- APlace the client in a room near the nurses' station for close observation✓ 正解將病人安置在護理站附近的病房以便密切觀察
- BApply physical restraints to keep the client in bed使用身體約束具將病人固定在床上
- CEncourage the client to participate in high-intensity exercise before bed鼓勵病人在睡前參與高強度運動
- DAdminister PRN sedative medications給予按需（PRN）鎮靜藥物
— Explanation · 中文詳解 —
針對失智症遊走，優先考慮非侵入性的安全策略。將病人安置於護理站旁（近處監測）可提升觀察力並給予安全感，減少病人獨處造成的焦慮。約束與藥物均為最後手段，僅在嚴重影響安全時使用；劇烈運動在夜間會使病人更興奮，不利於休息。
For wandering in dementia, non-invasive safety strategies are preferred. Placing the client in a room near the nurses' station enhances observation and provides a sense of security, reducing the anxiety associated with being alone. Restraints and medications are last-resort options, used only when safety is severely compromised. Vigorous exercise at night increases agitation and is detrimental to rest.
✦ 台美臨床差異
美國護理機構極度重視「限制約束」（Restraint reduction）政策；台灣在長照或急性病房，對於約束仍需醫師開立醫囑，執行規範嚴謹。