護理師照顧一位有癲癇病史的病人。哪些護理措施適合維持其安全？（選所有適合的）
A nurse is caring for a client with a history of seizures. Which interventions are appropriate to maintain safety? (Select all that apply.)
- APad the side rails of the bed✓ 正解在床欄上加裝襯墊
- BKeep a tongue blade at the bedside在床邊備妥壓舌板
- CMaintain the bed in the lowest position✓ 正解將病床調整至最低位置
- DEnsure suction equipment is available✓ 正解確保抽吸設備可用
- EInsert an oral airway when the seizure starts癲癇發作時插入口腔通氣管
癲癇發作護理的核心在於「預防傷害」與「保護氣道」。護理師應採取環境安全措施（如加裝床欄軟墊、降低床位），以防病人發作時因抽搐撞擊床欄而造成外傷。此外，備妥抽吸設備是為了在發作結束後，確保能立即清除可能阻塞氣道的口腔分泌物。現代護理實務已明確禁止在發作中使用壓舌板或強行置入口腔呼吸道，因為這些動作極易導致病人牙齒斷裂、口腔黏膜受損，甚至造成護理師的手指被咬傷，不符合安全原則。
The core of seizure care is "injury prevention" and "airway protection." The nurse should implement environmental safety measures (such as padding the side rails and lowering the bed) to prevent the client from injuring themselves by striking the side rails during convulsive movements. In addition, having suction equipment available is essential so that, after the seizure ends, any oral secretions that might obstruct the airway can be cleared immediately. Modern nursing practice clearly prohibits the use of a tongue blade or forced insertion of an oral airway during a seizure, as these actions are highly likely to fracture the client's teeth, injure the oral mucosa, or even result in injury to the nurse's fingers from biting, and therefore do not meet the principles of safety.
美國臨床實務對於「床邊放置壓舌板」的觀點已完全排除，護理教學中強調「不要在發作中嘗試放任何東西進病人嘴裡」。台灣部分老舊觀念可能仍殘留放置壓舌板的習慣，請務必更新為 NCLEX 的標準做法。