針對留置鼻胃管的病人，哪些口腔衛生習慣是推薦的？（選所有適合的）

留置鼻胃管（nasogastric, NG tube）的病人，由於管路經過鼻腔和咽喉，可能引起鼻黏膜乾燥、刺激，以及口腔黏膜乾燥、異味。因此，維持良好的口腔衛生（oral hygiene）和鼻腔護理（nasal care）至關重要，以預防感染和提升舒適度。 正確選項分析： A. 每日刷牙兩次（Brush teeth twice daily）：規律的口腔清潔有助於清除食物殘渣和細菌，預防齲齒、牙齦炎和口腔異味。 C. 清潔管路周圍的鼻孔（Clean the nares around the tube）：鼻胃管插入處的皮膚可能因分泌物或壓力而受損。輕柔清潔並保持乾燥，可預防皮膚破裂或感染。 D. 在鼻孔塗抹水溶性潤滑劑（Apply water-soluble lubricant to the nares）：管路可能摩擦鼻黏膜，導致乾燥或結痂。水溶性潤滑劑（water-soluble lubricant）能保持鼻腔濕潤，緩解不適，但必須是水溶性的，以防油性物質被吸入肺部造成吸入性肺炎（lipoid pneumonia）。 錯誤選項分析： B. 使用含酒精的漱口水（Use mouthwash containing alcohol）：酒精會使口腔黏膜乾燥，加劇不適感，且對鼻胃管病人並無特別益處，應避免。 E. 拔除管路前避免任何口腔護理（Avoid any mouth care until the tube is removed）：這是錯誤且有害的。口腔護理對預防感染、維持病人舒適度至關重要，不應因留置鼻胃管而停止。 臨床思路：ABC 原則中的 A（Airway）是關鍵。鼻腔和口腔的護理直接關係到呼吸道的健康。預防感染（Infection prevention）是核心目標。病人舒適度（Comfort）也是重要考量。

Because the nasogastric (NG) tube passes through the nasal cavity and pharynx, the client may experience nasal mucosal dryness and irritation as well as oral mucosal dryness and unpleasant odor. Maintaining good oral hygiene and nasal care is therefore essential to prevent infection and improve comfort. Analysis of correct options: A. Brushing teeth twice daily: regular oral cleansing helps remove food debris and bacteria, preventing dental caries, gingivitis, and oral malodor. C. Cleaning the nares around the tube: the skin where the NG tube enters the nose may be damaged by secretions or pressure. Gentle cleaning to keep the area dry helps prevent skin breakdown and infection. D. Applying water-soluble lubricant to the nares: the tube can rub against the nasal mucosa, causing dryness or crusting. Water-soluble lubricant keeps the nasal passages moist and relieves discomfort. The lubricant must be water-soluble to avoid the risk of lipoid pneumonia from aspirated oily substances. Analysis of incorrect options: B. Using mouthwash containing alcohol: alcohol dries the oral mucosa and worsens discomfort, and it offers no particular benefit to clients with an NG tube, so it should be avoided. E. Avoiding any mouth care until the tube is removed: this is incorrect and harmful. Oral care is essential to prevent infection and maintain comfort, and it should not be discontinued because the NG tube is in place. Clinical reasoning: the A in the ABC principle (Airway) is key. Care of the nasal and oral cavities is directly tied to airway health. Infection prevention is a core goal, and client comfort is also an important consideration.