護理師照顧一位有新造口（colostomy）的病人，哪項護理措施對於預防造口周圍感染和皮膚破損至關重要？
A nurse is caring for a client with a new colostomy. Which nursing action is essential for preventing infection and skin breakdown around the stoma?
- AApply a barrier cream liberally to the peristomal skin.大量塗抹屏障霜於造口周圍皮膚
- BClean the peristomal skin gently with mild soap and water, and ensure it is completely dry.✓ 正解用溫和肥皂和水輕輕清潔造口周圍皮膚，並確保完全乾燥
- CChange the ostomy appliance only when it leaks.僅在造口裝置滲漏時更換
- DUse alcohol-based wipes to clean the stoma site.使用含酒精的濕巾清潔造口部位
造口（ostomy）照護的目標是維持造口周圍皮膚的完整性，預防感染和破損，並確保造口袋的密合。正確答案 B 指出「溫和清潔造口周圍皮膚，並確保完全乾燥」，這是預防感染和皮膚問題的基石。排泄物（糞便或尿液）對皮膚具有強烈的刺激性，若皮膚長期處於潮濕或受刺激的狀態，容易破損、發炎，甚至形成潰瘍。因此，每次更換造口袋時，仔細清潔並徹底擦乾是保護皮膚的首要步驟。選項 A（塗抹 barrier cream）有助於保護皮膚，但前提是皮膚已清潔乾燥。選項 C（僅在滲漏時更換）可能導致皮膚長時間暴露於排泄物下，增加風險。選項 D（使用含酒精的濕巾）可能過度刺激或乾燥皮膚，不適合用於造口周圍的嬌嫩皮膚。
The goal of ostomy care is to maintain the integrity of the peristomal skin, prevent infection and breakdown, and ensure a tight seal of the ostomy appliance. Correct answer B states 'gently cleanse the peristomal skin and ensure it is completely dry,' which is the cornerstone of preventing infection and skin problems. Excreta (stool or urine) are highly irritating to the skin; prolonged moisture or irritation leads to breakdown, inflammation, and possibly ulceration. Therefore, careful cleansing and thorough drying with each appliance change is the first step in protecting the skin. Option A (apply barrier cream) helps protect the skin but only on the premise of cleansed, dry skin. Option C (change only when leaking) can expose skin to excreta for extended periods, increasing risk. Option D (use alcohol-based wipes) can be overly irritating or drying and is not suitable for the delicate peristomal skin.
無顯著差異。造口護理的原則，包括清潔、乾燥造口周圍皮膚的重要性，在台灣與美國的臨床實務中是相同的。兩地都會教導病人和護理人員使用溫和的清潔劑，並確保皮膚完全乾燥後再黏貼新的造口袋。