一位患有尿路感染的病人被醫囑要求每日增加飲水量至 2,500 毫升。護理師應採取哪種策略最能達成此目標？
A client with a urinary tract infection is ordered to increase fluid intake to 2,500 mL per day. Which strategy should the nurse implement to best achieve this goal?
- AForce the client to drink 500 mL of water with each meal強迫客戶每餐飲用 500 毫升的水
- BAsk the family to bring in caffeinated sodas that the client enjoys請家屬帶來客戶喜歡的含咖啡因汽水
- CSet a schedule with small, frequent amounts of fluid throughout the day✓ 正解制定全天少量多次飲水的時間表
- DProvide most of the fluid during the evening and night hours在傍晚和夜間提供大部分的水分
增加飲水量的護理重點在於「分段達標」與「減少排尿對睡眠的干擾」。將 2,500 毫升平均分配在日間（例如早上 7 點到晚上 7 點完成 80%），採取少量多次的方式，能提高病人的依從性，避免單次飲用過多造成的腹脹不適。選項 D 會導致夜尿頻繁影響睡眠；B 選項的咖啡因具有利尿作用，反而可能加重脫水，且糖分過高不利感染恢復；A 選項的「強迫」方式容易引發病人反感或嘔吐。護理師應與病人協商飲水時間表，並利用記錄單讓病人參與自我管理，這對於老年病人尤為重要。
Key points for increasing fluid intake are "meeting the goal in segments" and "reducing sleep disruption due to urination." Distributing 2,500 mL evenly during the daytime (for example, completing 80% between 7 a.m. and 7 p.m.) and providing small, frequent amounts improves adherence and avoids the abdominal distention and discomfort of drinking large volumes at once. Option D leads to frequent nocturia and disturbed sleep; the caffeine in option B is a diuretic and may worsen dehydration, while excess sugar is unhelpful for recovery from infection; option A's "forced" approach is likely to provoke refusal or vomiting. The nurse should negotiate a drinking schedule with the client and use a recording sheet to engage the client in self-management, which is especially important for older adults.
美國護理教育非常強調讓病人參與計畫（Involve the client in the plan of care）。在台灣，護理師有時會直接將水壺放在床頭要求家屬督促，較少細緻地與病人共同規劃小時進水量，這在 NCLEX 考試中是重要的概念差異。