護理師為糖尿病病人進行足部護理，應採取哪些行動？（選所有適合的）

糖尿病（Diabetes Mellitus）病人因長期高血糖，容易引起周邊血管病變（peripheral vascular disease）與神經病變（neuropathy），進而影響足部血液循環與感覺，使其對傷口、感染的抵抗力下降，且不易察覺細微損傷。因此，足部護理是糖尿病照護中極為重要的一環，旨在預防潰瘍、感染及截肢。 正確選項分析： A. 每日檢查足部（Inspect feet daily）：這是預防糖尿病足潰瘍的基石。仔細觀察有無紅腫、水泡、割傷、裂痕、趾間濕疹等，能及早發現問題並處理。 C. 用溫水洗腳（Wash feet in lukewarm water）：溫水（約攝氏 37-40 度）能溫和清潔，避免因感覺減退而燙傷，水溫過高會造成燙傷，水溫過低則清潔效果不佳。 D. 指甲平剪（Cut toenails straight across）：修剪指甲時應採直線方式，避免修剪過深或圓角，以防造成甲溝炎（paronychia）或嵌甲（ingrown toenails），進而引發感染。 E. 穿著純棉襪（Wear cotton socks）：棉質襪子透氣性好，能吸收足部汗水，保持足部乾爽，減少黴菌滋生，並提供緩衝。 錯誤選項分析： B. 乳液塗抹於趾縫間（Apply lotion between the toes）：腳趾之間的皮膚容易潮濕，若塗抹乳液，會使該區域更加潮濕，有利於黴菌（如念珠菌）滋生，引發足癬（athlete's foot）或其他真菌感染。乳液應塗抹在足部皮膚，避開趾縫。 臨床思路：ABC 原則適用於糖尿病足護理，特別是 A（Airway）對應到預防傷口（預防感染進入血液循環），B（Breathing）對應到維持組織灌流（預防血管病變），C（Circulation）對應到預防傷口與感染。護理師需教育病人正確的自我照護知識，並定期專業評估。

Because of chronic hyperglycemia, clients with diabetes mellitus are prone to peripheral vascular disease and neuropathy, which impair circulation and sensation in the feet. This decreases resistance to wounds and infection and makes minor injuries difficult to detect. Foot care is therefore an essential component of diabetes management, aimed at preventing ulcers, infections, and amputation. Analysis of correct options: A. Inspect feet daily: This is the cornerstone of preventing diabetic foot ulcers. Careful inspection for redness, blisters, cuts, fissures, or interdigital maceration allows early detection and intervention. C. Wash feet in lukewarm water: Lukewarm water (approximately 37-40 degrees C) provides gentle cleansing while avoiding burns in clients with decreased sensation; water that is too hot may cause burns, and water that is too cool is ineffective for cleaning. D. Cut toenails straight across: Trimming the nails straight across, rather than rounded or too short, helps prevent paronychia and ingrown toenails, which can lead to infection. E. Wear cotton socks: Cotton socks are breathable and absorb perspiration, keeping the feet dry, reducing fungal growth, and providing cushioning. Analysis of incorrect options: B. Apply lotion between the toes: The skin between the toes is already prone to moisture; applying lotion there increases dampness and promotes fungal infections such as athlete's foot. Lotion should be applied to the rest of the foot but kept out of the interdigital spaces. Clinical reasoning: The ABC framework can be applied to diabetic foot care: A (Airway) corresponds to preventing wounds from becoming portals of infection; B (Breathing) corresponds to maintaining tissue perfusion (preventing vascular complications); and C (Circulation) corresponds to preventing wounds and infection. The nurse must educate the client about proper self-care and ensure regular professional foot assessments.