— 心理社會完整性 · HARD · MCQ —
一位厭食症個案因嚴重營養不良入院。進食時間時，下列哪項護理措施最有效？
A client with anorexia nervosa is admitted for severe malnutrition. During mealtime, which action by the nurse is most effective?
- AMonitor the client during and for 60 minutes after meals✓ 正解在進食期間及進食後 60 分鐘內監測病人
- BFocus conversation on topics unrelated to food and calories將對話焦點放在與食物和熱量無關的主題上
- CAllow the client to choose what they want to eat允許病人選擇他們想吃的食物
- DEncourage the client to finish all food on the tray鼓勵病人吃完餐盤中的所有食物
— Explanation · 中文詳解 —
厭食症護理的核心在於防止隱藏食物或飯後催吐。進食後 60 分鐘內持續觀察是標準規範，確保營養攝取並避免代償行為。進食時應營造放鬆氛圍，不刻意談論食物或強迫進食量，以免增加個案的焦慮，進而觸發防禦機制或拒食行為。
In anorexia nervosa care, the priority during and after meals is direct observation to prevent hiding food or purging (self-induced vomiting). Monitoring for at least 60 minutes after meals is standard. Conversations should be neutral and not focused on food/calories, and forcing intake creates power struggles. A structured prescribed meal plan is typically more therapeutic than allowing free choice.
✦ 台美臨床差異
美台臨床皆重視飯後觀察，但在美國醫院常有專責的一對一照護員，台灣則多仰賴護理師或家屬協助。