護理師照顧一位患有周邊神經病變的病人。下列哪些措施有助於促進其安全性？（選所有適合的）

核心概念：周邊神經病變（Peripheral Neuropathy）是指影響周邊神經系統的疾病，常導致感覺喪失（包括痛覺、溫度覺、觸覺）、運動功能障礙或自主神經功能異常。這些症狀會顯著增加病人受傷的風險，特別是足部，因此在照護中必須優先考量安全性。 為何正確答案 A, B, D 對： A. 每日檢查足部（inspect feet daily）對於周邊神經病變病人至關重要。由於感覺減退，他們可能無法察覺到微小的傷口、紅腫、水泡或潰瘍，若不及時發現和處理，可能迅速惡化並導致感染甚至截肢。 B. 泡澡或淋浴前測試水溫（check water temperature）是預防燙傷的關鍵。感覺異常的病人無法準確感知水溫，可能使用過熱的水而不知，造成嚴重燙傷。 D. 穿著合適且支撐性良好的鞋子（well-fitted, supportive shoes）能保護足部免受外傷，減少摩擦，並提供穩定性，預防行走時的跌倒或扭傷。 為何選項 C, E 錯： C. 使用加熱墊（heating pad）來改善循環，對周邊神經病變病人而言風險極高。由於感覺減退，他們可能無法感知加熱墊的溫度，長時間接觸極易造成深度燙傷（deep burns），甚至引起組織壞死。 E. 在腳趾間塗抹保濕劑（moisturizer）可能導致皮膚過度濕潤（maceration），增加黴菌滋生和皮膚破損的機會，尤其是在感覺異常、不易察覺初期問題的情況下，這反而會增加感染風險。 臨床思路（Safety / Priority）：此題的臨床思路是「病人安全」。周邊神經病變的核心風險是感覺喪失導致的損傷。因此，所有措施都應圍繞著「預防傷害」展開。

Core concept: peripheral neuropathy refers to disorders of the peripheral nervous system that often cause sensory loss (including pain, temperature, and tactile sensation), motor dysfunction, or autonomic dysfunction. These symptoms substantially increase the client's risk of injury, especially to the feet, so safety must be the priority in care. Why options A, B, and D are correct: A. Daily foot inspection is essential for clients with peripheral neuropathy. Because of decreased sensation, they may not perceive small wounds, redness, blisters, or ulcers, which can rapidly worsen and lead to infection or even amputation if not detected and treated promptly. B. Checking water temperature before bathing or showering is key to preventing burns. Clients with abnormal sensation cannot accurately perceive temperature and may unknowingly use water that is too hot, causing serious burns. D. Wearing well-fitted, supportive shoes protects the feet from trauma, reduces friction, and provides stability, helping to prevent falls and sprains during walking. Why options C and E are incorrect: C. Using a heating pad to improve circulation poses an extremely high risk for clients with peripheral neuropathy. Because of decreased sensation, they cannot perceive the temperature of the pad, and prolonged contact can readily cause deep burns and even tissue necrosis. E. Applying moisturizer between the toes can lead to excessive moisture (maceration), promoting fungal growth and skin breakdown, particularly in those who cannot easily detect early problems, thereby increasing the risk of infection. Clinical reasoning (safety/priority): the focus of this question is patient safety. The core risk of peripheral neuropathy is sensory loss leading to injury, so all interventions should center on "injury prevention."

周邊神經病變（Peripheral Neuropathy）的照護原則在美國和台灣基本相同，都強調足部保護、避免高溫、穿著合適鞋襪、每日檢查等。美國的醫療系統可能更強調病人教育和居家照護計畫的完整性，並可能使用更標準化的評估工具。台灣在醫療資源分配上可能有所差異，但核心照護理念一致。