一位高齡病人有夜間失眠困擾。護理師在照護計畫中應納入下列哪項措施？
A nurse is caring for an older adult client who has difficulty sleeping at night. Which nursing intervention should the nurse include in the plan of care?
- AIncrease fluid intake during the late evening hours在傍晚後期增加液體攝取量
- BEncourage a consistent bedtime routine and limit daytime napping✓ 正解鼓勵固定的就寢常規並限制白天小睡
- CAdminister a hypnotic medication every night at bedtime每晚睡前給予催眠藥物
- DKeep the room lights on to prevent confusion during the night保持房間燈光亮起以預防夜間意識混亂
高齡者失眠的護理核心在於恢復生理節律（Circadian Rhythm）。正確答案 B 透過建立「睡眠衛生（Sleep Hygiene）」習慣，如固定作息與限制日間睡眠，能有效增強夜間的睡眠驅力。反之，藥物、水分攝取與光線調節均可能產生副作用或干擾睡眠生理，護理師應優先採用非藥物介入措施，以落實病人安全。
The core of nursing care for insomnia in older adults is restoring the circadian rhythm. Option B, by establishing sleep hygiene habits such as a consistent schedule and limited daytime napping, effectively strengthens the sleep drive at night. Conversely, medications, fluid intake, and lighting adjustments can cause side effects or disrupt sleep physiology; the nurse should give priority to non-pharmacologic interventions to ensure patient safety.
在美國臨床，護理師對高齡者用藥極為謹慎，特別是針對 Beers Criteria（高齡者不適當用藥清單）中的藥物，會優先嘗試非藥物性介入（Non-pharmacologic interventions）。