ICU 病人需減少睡眠中斷。哪些護理措施是正確的？（選所有適合的）
A client in the ICU needs to minimize sleep fragmentation. Which nursing interventions are appropriate? (Select all that apply.)
- ACluster nursing tasks✓ 正解集中護理工作
- BDim the lights at night✓ 正解夜間調暗燈光
- CPerform all assessments at once✓ 正解一次性執行所有評估
- DMinimize noise levels✓ 正解最小化噪音水平
- EWake the client for all routine medications為所有常規藥物喚醒病人
ICU 病房的環境噪音、頻繁的醫療介入與持續的燈光常導致病人出現「ICU 譫妄（ICU Delirium）」或睡眠剝奪。護理介入的核心概念是「集中護理（Clustering care）」，即將多項護理活動（如抽血、換藥、翻身、評估）安排在同一時段完成，以保留較長的連續睡眠區塊。此外，環境調控（調暗燈光、降低噪音）有助於維持晝夜節律（Circadian rhythm）。臨床思路上，應區分「必要醫療」與「常規處置」，對於非緊急的常規藥物或檢查，應盡量避免在病人的深度睡眠期執行。
Environmental noise in the ICU, frequent medical interventions, and constant lighting often lead to ICU delirium or sleep deprivation. The core concept of nursing intervention is clustering care, which means grouping multiple nursing activities (such as blood draws, dressing changes, turning, and assessments) into the same time period in order to preserve longer blocks of continuous sleep. Environmental modulation (dimming the lights and reducing noise) also helps maintain the circadian rhythm. Clinically, it is important to distinguish 'essential medical care' from 'routine procedures'; for non-urgent routine medications or examinations, the nurse should try to avoid performing them during the client's periods of deep sleep.
美國醫護團隊對於「ICU 譫妄」的預防非常重視，Cluster Care 是標準作業程序；台灣部分醫院可能仍習慣依固定時間點執行常規治療，較少彈性調整以配合病人睡眠。