護理師照護一位已臥床三天的老年病人。下列哪項措施對於預防壓力性損傷（壓瘡）最有效？
A nurse is caring for an older adult client who has been on bed rest for three days. Which action is most effective in preventing the development of pressure injuries?
- ARepositioning the client at least every 2 hours✓ 正解至少每 2 小時協助病人翻身
- BApplying a thick layer of cornstarch to the groin area在腹股溝區域塗抹厚層玉米粉
- CMassaging reddened bony prominences every 4 hours每 4 小時按摩發紅的骨突處
- DPlacing a rubber ring cushion under the client's sacrum在病人薦骨下方放置橡膠圈坐墊
預防壓力性損傷的核心在於「減壓」。對於長期臥床病人，每 2 小時翻身一次是臨床公認最具成本效益且有效的黃金標準。這能確保局部組織不會因持續受壓而導致缺血壞死。老年人皮膚較薄，更需注意翻身時的剪力。選項 C 是過時且錯誤的做法，按摩發紅部位會加重組織微血管受損；B 選項的玉米粉在潮濕處易結塊磨損皮膚；D 選項的橡皮圈（甜甜圈墊）會造成邊緣壓力過大，阻礙中心循環，目前在實證醫學中已明確被禁止用於預防壓瘡。護理師應評估 Braden Scale 並落實定時翻身。
The core of pressure injury prevention is pressure relief. For long-term bedridden patients, repositioning every 2 hours is the clinically accepted, cost-effective gold standard. This ensures that local tissues are not subjected to continuous pressure leading to ischemic necrosis. Older adults have thinner skin and require special attention to shearing during repositioning. Option C is an outdated and incorrect practice; massaging reddened areas worsens microvascular tissue damage. Option B's cornstarch can clump in moist areas and abrade the skin. Option D's rubber ring cushion (donut cushion) creates excessive pressure at the edges, impairing central circulation, and is explicitly contraindicated in evidence-based practice for pressure injury prevention. The nurse should assess with the Braden Scale and implement scheduled repositioning.
美國 NCLEX 非常強調「不得按摩骨突處」及「嚴禁使用環狀墊」。台灣部分資深護理人員或家屬仍有按摩能促進循環的舊觀念，護理師需透過衛教更新臨床執業標準，避免造成醫源性損傷。