護理師正在協助一位左側肢體無力的病人使用助行杖行走。護理師的哪項行為顯示其對使用助行杖的安全性有正確的理解？
A nurse is assisting a client with left-sided weakness to ambulate using a cane. Which action by the nurse demonstrates a correct understanding of cane safety?
- AEncouraging the client to move the cane forward first, followed by the left leg.✓ 正解鼓勵病人先移動拐杖，接著移動左腿
- BInstructing the client to hold the cane in the left hand.指示病人將拐杖握在左手
- CPlacing the cane 6 to 10 inches in front of the right foot.將拐杖置於右腳前方 6 至 10 英吋處
- DEnsuring the client keeps their elbows straight while holding the cane.確保病人手持拐杖時手肘伸直
此題的核心概念是單點助行杖（Cane）的正確使用順序。病人應將助行杖握在強健側（此題為右側），以增加支撐面積。行進順序為：助行杖先往前移，接著移動患肢（左腿），最後移動健肢（右腿）。這樣的順序確保在患肢著地時，助行杖能提供額外的穩定性與荷重分配。這符合護理安全原則中的『維持重心平衡』與『預防跌倒』。錯誤選項中，握在患肢側會導致重心不穩；直手拿杖會導致肌肉疲勞且無法緩衝重量；正確的彎曲角度應為 15-30 度。臨床護理師必須準確評估病人的協調性與肌力，確保輔具使用不會反而增加受傷風險。
The core concept is correct use of a single-point cane. The cane should be held in the stronger hand (right in this case) to enlarge the support base. The gait sequence: advance the cane, then the weaker leg, then the stronger leg. This ensures cane support during weaker-leg stance, fitting safety principles of balance and fall prevention. Holding the cane on the weaker side destabilizes balance; straight elbows fatigue muscles and cannot absorb shock; the correct elbow angle is 15-30 degrees. The nurse must accurately assess coordination and strength to ensure assistive device use does not increase injury risk.
在美國，物理治療師（PT）通常負責初步的輔具衛教，護理師則負責日常活動的加強與安全監督。台灣臨床上，病房護理師常需承擔更多的初次衛教職責。此外，美國對輔具調整（如高度調整）有嚴格的職業規範限制，台灣則較常由護理師直接協助調整。