— 基本照護與舒適 · MEDIUM · MCQ —
護理師照護一位尿失禁病人。下列哪種策略最能促進皮膚完整性？
A nurse is caring for a client with urinary incontinence. Which strategy is best to promote skin integrity?
- AUse an indwelling catheter to keep the client dry使用留置導尿管以保持病人乾燥
- BWash the area with soap and water after every episode每次失禁後用肥皂和水清洗該區域
- CApply a barrier cream after gently cleansing the skin✓ 正解輕輕清潔皮膚後塗抹保護性藥膏
- DChange the absorbent pad only when it is saturated僅在吸收墊完全飽和時才更換
— Explanation · 中文詳解 —
尿失禁皮膚照護核心為：溫和清潔、擦乾、保護。給予保護膏（Barrier cream）可有效隔絕尿液刺激。留置導尿管雖可保持乾燥，但感染風險極高，非首選。不可等尿布吸飽才換，會增加浸潤時間。過度使用肥皂會破壞皮膚酸鹼值，應選擇弱酸性清潔液。
Skin care for urinary incontinence centers on gentle cleansing, drying, and protection. Barrier creams effectively shield skin from urine irritation. Indwelling catheters keep skin dry but markedly increase infection risk and are not first-line. Pads should be changed promptly, not waited until saturated. Soap can disrupt skin pH; a pH-balanced cleanser is preferred.
✦ 台美臨床差異
美國醫院對 CAUTI 的追蹤極嚴，非常避免使用導尿管，台灣亦有此趨勢，但臨床導尿管使用比例仍高。