針對皮膚搔癢的病人，哪些護理措施能促進舒適感？（選所有適合的）

皮膚搔癢（pruritus）是一種常見的症狀，可能由多種原因引起，如皮膚乾燥、過敏、濕疹、蟲咬等。搔癢會嚴重影響病人的舒適度，甚至干擾睡眠和日常生活。護理措施應著重於緩解搔癢感、預防進一步的皮膚損傷。 正確選項分析： A. 使用乳液保持皮膚濕潤（Keeping the skin hydrated with lotions）：皮膚乾燥是引起搔癢的常見原因。適時塗抹無香料、溫和的乳液（lotion）能鎖住水分，維持皮膚屏障功能，減緩乾燥引起的搔癢。 B. 維持涼爽的環境（Maintaining a cool environment）：高溫和濕熱會使皮膚血管擴張，加劇搔癢感。涼爽的環境有助於降低皮膚溫度，舒緩搔癢。 D. 冰敷（Applying cold compresses）：冷敷能暫時麻痺神經末梢，降低皮膚溫度，達到暫時緩解搔癢的效果。這是非藥物性的止癢方法。 錯誤選項分析： C. 使用熱水洗澡（Using hot water for bathing）：熱水會使皮膚血管擴張，帶走皮膚的天然油脂，使皮膚更加乾燥，進而加劇搔癢感。應避免使用過熱的水。 E. 鼓勵病人頻繁抓撓（Encouraging the client to scratch frequently）：雖然抓撓能暫時緩解搔癢，但頻繁抓撓會損傷皮膚表皮，破壞皮膚屏障，引發炎症反應，甚至造成繼發性感染，形成「搔癢-抓撓循環」（itch-scratch cycle），使搔癢更加嚴重。因此，應教導病人避免抓撓。 臨床思路：ABC 原則中的 A（Airway）對應到維持皮膚完整性（預防感染），B（Breathing）對應到深呼吸放鬆（有助於減緩搔癢感），C（Circulation）對應到皮膚的血液循環（避免過度擴張加劇搔癢）。

Pruritus (itching) is a common symptom that may be caused by various factors such as dry skin, allergies, eczema, or insect bites. Itching can significantly affect the client's comfort and may interfere with sleep and daily activities. Nursing measures should focus on relieving the itching sensation and preventing further skin damage. Analysis of correct options: A. Keeping the skin hydrated with lotions: Dry skin is a common cause of itching. Regular application of fragrance-free, gentle lotion locks in moisture, maintains the skin barrier function, and relieves itching caused by dryness. B. Maintaining a cool environment: Heat and humidity cause cutaneous vasodilation and intensify itching. A cool environment helps lower skin temperature and soothe the itch. D. Applying cold compresses: Cold compresses can temporarily numb nerve endings and lower skin temperature, providing temporary relief of itching. This is a non-pharmacological method. Analysis of incorrect options: C. Using hot water for bathing: Hot water dilates skin blood vessels and strips natural oils from the skin, making the skin drier and worsening the itch. Excessively hot water should be avoided. E. Encouraging the client to scratch frequently: Although scratching may provide temporary relief, frequent scratching damages the epidermis, breaks down the skin barrier, triggers inflammation, and can cause secondary infection, creating an itch-scratch cycle that worsens the itching. Clients should therefore be taught to avoid scratching. Clinical reasoning: Under the ABC framework, A (Airway) corresponds to maintaining skin integrity (preventing infection), B (Breathing) corresponds to deep breathing and relaxation (which helps reduce the sensation of itching), and C (Circulation) corresponds to skin circulation (avoiding excessive vasodilation that worsens itching).