— 心理社會完整性 · EASY · MCQ —
一位患有阿茲海默症的長者在走廊來回踱步且顯得焦躁。護理師最合適的處置為何？
An elderly client with Alzheimer's dementia is pacing the halls and appears agitated. Which action by the nurse is most appropriate?
- AProvide a simple, structured activity to redirect the client✓ 正解提供簡單的結構化活動以轉移客戶注意力
- BRestrain the client to prevent potential falls約束客戶以防止潛在跌倒
- CAdminister a PRN sedative to reduce agitation給予備用鎮靜劑以減輕焦慮
- DDirect the client to return to their room immediately指示客戶立即返回房間
— Explanation · 中文詳解 —
針對失智症病人的踱步（pacing），通常是源於無聊、焦慮或生理需求未被滿足。轉移注意力（redirection）提供簡單活動是最佳實務。A 可能導致病人反抗；B 藥物應為最後手段；D 約束具會增加失智者混亂與跌倒風險，除非有明確立即危險。
Pacing in clients with dementia commonly stems from boredom, anxiety, or unmet physiological needs. Redirection by offering a simple activity is best practice. Option D may provoke resistance; Option C reserves medication as a last resort; and Option B—physical restraints—increases confusion and the risk of falls in clients with dementia and should only be used when there is a clear and immediate danger.
✦ 台美臨床差異
美國法規對約束（restraints）管理極度嚴格，強調「無約束照護」；台灣醫院同樣推廣，但家屬對於不約束的病安焦慮感通常較高。