一位高齡病人主訴有頻繁的夜尿，且夜尿後難以再次入睡。護理師應優先實施哪項介入措施？
An older adult client reports frequent nocturia and difficulty falling back to sleep. Which intervention should the nurse implement first?
- AEncourage the client to use a bedside commode鼓勵病人使用床邊便盆椅
- BAdminister a prescribed sedative at bedtime睡前給予處方鎮靜劑
- CAssess the client's daytime caffeine consumption評估病人的日間咖啡因攝取量
- DLimit fluid intake in the evening and before sleep✓ 正解限制傍晚及睡前的液體攝取
夜尿（Nocturia）是老年人睡眠中斷最常見的原因之一。處理睡眠問題應遵循「最少侵入性」原則。首先，應從生活習慣調整開始，即減少睡前與傍晚的液體攝取量（選項 D），這能直接減少夜間膀胱充盈，降低起床排尿的次數。雖然選項 C（評估咖啡因）也很重要，但針對夜尿這一直接主訴，限水是更優先的處置。選項 B（鎮靜劑）在老年人身上有極高風險（導致跌倒、瞻妄），應為最後手段。選項 A（床邊便盆椅）雖能增加安全感，但無法減少夜尿次數，也不是解決「入睡困難」的首選。護理師應先確認病人的水分管理，再進行其他睡眠衛生評估。
Nocturia is one of the most common causes of sleep interruption in older adults. Management of sleep problems should follow the principle of 'least invasive first.' Initial measures should focus on lifestyle modifications, namely reducing fluid intake before bedtime and in the evening (option D), which directly reduces nocturnal bladder filling and decreases the frequency of nighttime urination. Although option C (assessing caffeine) is also important, for the direct complaint of nocturia, fluid restriction is the higher priority. Option B (sedatives) carries a very high risk in older adults (falls, delirium) and should be the last resort. Option A (bedside commode) improves safety but does not reduce nocturia frequency, nor does it directly address difficulty falling back asleep. The nurse should first address fluid management before conducting other sleep hygiene assessments.
美國護理高度強調「跌倒預防」與「非藥物睡眠啟動」。在 NCLEX 中，任何能透過行為改變而非藥物解決的問題，答案通常傾向行為干預。台灣臨床上，病人有時會主動要求安眠藥，護理師需花更多時間進行生活習慣衛教，說明藥物副作用。