護理師指導一位新診斷第二型糖尿病的病人關於足部照護的知識，下列哪些回應顯示病人需要進一步衛教？（選所有適合的）
A nurse is teaching a client with newly diagnosed Type 2 Diabetes about foot care. Which statements by the client indicate a need for further teaching? (Select all that apply.)
- AI will soak my feet in hot water every night to keep them soft.✓ 正解我每天晚上會用熱水泡腳以保持柔軟。
- BI will trim my toenails straight across to prevent ingrown nails.我會將趾甲直線修剪以預防嵌甲。
- CI will check my feet daily using a mirror to see the bottoms.我會使用鏡子每天檢查腳底。
- DI will go barefoot at home to allow my feet to breathe.✓ 正解我會在室內赤腳以讓腳部透氣。
- EI will use a moisturizing lotion on my feet, but not between my toes.我會使用潤膚乳塗抹腳部，但不塗在趾縫間。
第二型糖尿病（Type 2 Diabetes Mellitus）的病人由於長期處於高血糖狀態，容易損害周邊神經和血管，導致足部感覺減退、血液循環不良，進而增加足部潰瘍、感染甚至截肢的風險。因此，足部照護是糖尿病管理中極為重要的一環，旨在預防外傷、感染和血循惡化。 護理師應教導病人採取一系列預防措施。病人若能正確理解並執行，表示衛教有效；若出現錯誤觀念，則表示需要進一步指導。 選項 A 錯誤，顯示病人需要進一步衛教。將雙腳浸泡在熱水中（Soak my feet in hot water）是非常危險的行為。糖尿病病人常有周邊神經病變，感覺遲鈍，無法準確感知水溫，容易因燙傷造成嚴重足部潰瘍，且熱水會使皮膚過度乾燥，增加龜裂風險。 選項 D 錯誤，顯示病人需要進一步衛教。赤腳在家行走（Go barefoot at home）會增加足部受到外傷（如被尖銳物刺傷、碰撞）的風險，而糖尿病足部的小傷口都可能發展成嚴重的感染或潰瘍，因此應避免赤腳。 選項 B 正確，表示病人理解。將趾甲修剪成直線（Trim my toenails straight across）並修圓邊角，可以預防指甲向內生長（Ingrown toenails），減少因修剪不當造成的傷口。 選項 C 正確，表示病人理解。每日檢查足部（Check my feet daily），並利用鏡子輔助檢查腳底，能及早發現任何異常，如紅腫、水泡、割傷或潰瘍。 選項 E 正確，表示病人理解。在足部塗抹保濕乳液（Use a moisturizing lotion on my feet）有助於防止皮膚乾燥和龜裂，但強調「不可塗抹於趾縫間」（but not between my toes），因為趾縫潮濕易滋生黴菌，引起香港腳（Athlete's foot），進而增加感染風險。 臨床思路：糖尿病足部照護的核心在於「預防」。透過教育病人正確的日常習慣，如選擇合適的鞋襪、每日檢查足部、安全修剪趾甲、適度保濕及避免傷害，來降低足部併發症的發生率。
Patients with type 2 diabetes mellitus are exposed to chronic hyperglycemia, which damages peripheral nerves and vessels, leading to decreased foot sensation and impaired circulation and thereby increasing the risk of foot ulceration, infection, and even amputation. For this reason, foot care is an extremely important component of diabetes management, aimed at preventing trauma, infection, and worsening circulation. The nurse should teach the patient a set of preventive measures. Correct understanding and execution indicates effective teaching; incorrect statements indicate the need for further instruction. Option A is incorrect and indicates that the patient needs further teaching. Soaking the feet in hot water is very dangerous. Patients with diabetes commonly have peripheral neuropathy with impaired sensation and cannot accurately perceive water temperature, making severe burns and foot ulceration more likely. In addition, hot water dries the skin excessively and increases the risk of cracking. Option D is incorrect and indicates that the patient needs further teaching. Walking barefoot at home increases the risk of foot trauma (such as punctures or impacts), and even minor wounds on a diabetic foot can develop into serious infection or ulceration. Therefore, going barefoot should be avoided. Option B is correct and indicates the patient understands. Trimming the toenails straight across and rounding the corners helps prevent ingrown toenails and reduces wounds caused by improper trimming. Option C is correct and indicates the patient understands. Daily inspection of the feet, using a mirror to inspect the soles, allows early detection of any abnormality such as redness, blisters, cuts, or ulceration. Option E is correct and indicates the patient understands. Applying moisturizing lotion to the feet helps prevent dryness and cracking, but the patient must "avoid applying it between the toes," because moisture between the toes encourages fungal growth, causing athlete's foot and increasing the risk of infection. Clinical reasoning: The core of diabetic foot care is prevention. Teaching the patient correct daily habits—choosing appropriate footwear, performing daily foot inspections, safely trimming the toenails, providing appropriate moisturization, and avoiding injury—reduces the incidence of foot complications.