— 照護管理 · MEDIUM · SATA —
對於診斷為急性譫妄的病人，下列哪些介入措施是適當的？（選所有適合的）
Which of the following interventions are appropriate for a client diagnosed with acute delirium? (Select all that apply.)
- AKeep the environment quiet and well-lit during the day✓ 正解白天保持環境安靜且照明充足
- BMaintain a consistent daily routine✓ 正解維持一致的每日作息
- CFrequently reorient the client to person, place, and time✓ 正解頻繁協助病人確認人、地、時定向
- DUse physical restraints to ensure client safety at all times隨時使用身體約束以確保病人安全
- EMinimize the number of different caregivers assigned✓ 正解減少指派照顧者的數量
— Explanation · 中文詳解 —
譫妄照護重點在於減少環境刺激與混亂。透過規律作息、適度光線、頻繁定向感訓練及減少看護輪替，能減輕病人的混亂感。不應過度使用約束（D），除非在其他無創性方法無效且有安全疑慮時，約束是最後手段且需醫師醫囑並頻繁評估。
Care for acute delirium focuses on reducing environmental confusion by maintaining a consistent routine, providing adequate daytime lighting, and frequently reorienting the client. Minimizing caregiver changes promotes stability, while physical restraints should only be used as a last resort when other non-invasive methods fail to ensure safety.
✦ 台美臨床差異
美國醫院極力推廣無約束照護，台灣因照護人力比問題，對約束的運用較為寬鬆，需特別注意倫理議題。