一位尿失禁病人，長期護理最有效的策略是什麼？
A nurse is caring for a client with urinary incontinence. Which strategy is most effective for long-term management?
- AUsing adult diapers at all times全天候使用成人紙尿褲
- BCatheterizing the client to keep skin dry對病人進行導尿以保持皮膚乾燥
- CLimiting all fluid intake限制所有液體攝取
- DEstablishing a bladder training schedule✓ 正解建立膀胱訓練計畫
尿失禁的長期管理目標在於恢復膀胱容量與控制力，而非僅是處理排泄物。膀胱訓練（Bladder training）透過逐漸延長排尿間隔，幫助病人重拾自主控制感，是目前臨床上的黃金標準。限制水分僅會造成脫水並增加尿液濃度，反而刺激膀胱；紙尿褲與導尿管皆屬於被動管理，過度依賴導尿管更會顯著增加導尿管相關尿路感染（CAUTI）的風險。
The long-term management goal for urinary incontinence is to restore bladder capacity and control, not merely to manage excretions. Bladder training, which gradually extends voiding intervals, helps the client regain a sense of autonomous control and is currently the clinical gold standard. Restricting fluids only causes dehydration and increases urine concentration, which further irritates the bladder; adult diapers and catheters are both passive management measures, and excessive reliance on catheters significantly increases the risk of catheter-associated urinary tract infection (CAUTI).
美國醫院對 CAUTI 的管控非常嚴格，護理師需每日評估導尿管的必要性（Daily nurse-led assessment），若無明確醫囑支持，護理師有權利且被鼓勵主動提出移除。