護理師指導 COPD 病人節能技巧，哪些建議是適當的？（選所有適合的）
A nurse is teaching a client with chronic obstructive pulmonary disease (COPD) about energy conservation. Which suggestions are appropriate? (Select all that apply.)
- AEat smaller, more frequent meals✓ 正解少量多餐
- BPerform all daily activities at once to finish early一次性完成所有日常活動以提早結束
- CUse a shower chair when bathing✓ 正解沐浴時使用沐浴椅
- DPractice pursed-lip breathing during exertion✓ 正解在活動時練習噘嘴呼吸
- EAvoid resting between tasks避免在任務之間休息
慢性阻塞性肺病（COPD）病人常有呼吸困難、容易疲倦的問題，因此學習能量節約（energy conservation）技巧，對維持其生活品質、減少呼吸急促（dyspnea）至關重要。 正確選項分析： A. 少量多餐（Eat smaller, more frequent meals）：消化食物需要能量，且脹滿的胃部會壓迫橫膈膜，加劇呼吸困難。少量多餐能減少每次進食的負擔，避免過度疲勞。 C. 洗澡時使用沐浴椅（Use a shower chair when bathing）：站立淋浴需要耗費大量體力。使用沐浴椅可以提供支撐，減少站立時間，節省能量，降低呼吸急促的風險。 D. 在費力時練習噘嘴呼吸（Practice pursed-lip breathing during exertion）：噘嘴呼吸（pursed-lip breathing）是一種呼吸技巧，能增加呼吸道壓力，延緩呼氣時間，促進氣體交換，減少呼吸道塌陷，有助於緩解呼吸急促。 錯誤選項分析： B. 將所有日常活動一次完成以求及早結束（Perform all daily activities at once to finish early）：這會導致病人一次消耗大量能量，引發嚴重的呼吸急促和疲勞，與能量節約的目標背道而馳。 E. 避免在任務之間休息（Avoid resting between tasks）：休息是能量節約的重要環節。應鼓勵病人將活動分段進行，並在任務之間安排充分的休息時間，讓身體得以恢復，避免過度疲勞。 臨床思路：ABC 原則中的 A（Airway）對應到呼吸道的通暢與效率，B（Breathing）是 COPD 病人的核心問題，C（Circulation）對應到維持足夠的氧氣供應。能量節約技巧旨在優化呼吸效率，減少耗氧量，維持循環穩定。
Clients with chronic obstructive pulmonary disease (COPD) commonly experience dyspnea and fatigue, so learning energy conservation techniques is essential for maintaining quality of life and reducing dyspnea. Analysis of correct options: A. Eat smaller, more frequent meals: Digestion requires energy, and a full stomach presses against the diaphragm, worsening dyspnea. Smaller, more frequent meals reduce the burden of each meal and avoid excessive fatigue. C. Use a shower chair when bathing: Standing in the shower expends significant energy. A shower chair provides support, reduces standing time, conserves energy, and decreases the risk of dyspnea. D. Practice pursed-lip breathing during exertion: Pursed-lip breathing is a technique that increases airway pressure, prolongs exhalation, promotes gas exchange, and reduces airway collapse, helping to relieve dyspnea. Analysis of incorrect options: B. Perform all daily activities at once to finish early: This causes the client to expend large amounts of energy at once, triggering severe dyspnea and fatigue and contradicting the goal of energy conservation. E. Avoid resting between tasks: Rest is an important component of energy conservation. Clients should be encouraged to break tasks into segments with adequate rest between them to allow recovery and prevent exhaustion. Clinical reasoning: In ABC terms, A (Airway) corresponds to airway patency and efficiency, B (Breathing) is the core problem for COPD patients, and C (Circulation) corresponds to maintaining adequate oxygen delivery. Energy conservation techniques optimize respiratory efficiency, reduce oxygen consumption, and help maintain circulatory stability.