一位高齡病人主訴皮膚乾燥、發癢。護理師應在衛生護理計畫中包含下列哪項措施？
An older client complains of dry, itchy skin. Which intervention should the nurse include in the hygiene care plan?
- AProvide a hot bath every morning to increase circulation.每天早上提供熱水澡以增加循環
- BApply moisturizer to the skin while it is still damp after bathing.✓ 正解洗澡後皮膚仍濕潤時塗抹保濕乳液
- CVigorously rub the skin dry with a towel to stimulate blood flow.用毛巾用力擦拭皮膚以刺激血液循環
- DAdd plenty of soap to ensure the skin is completely clean.添加大量肥皂以確保皮膚完全清潔
高齡者因皮脂腺分泌減少，皮膚極易乾燥。護理重點在於「鎖水」與「減少刺激」。洗澡後趁皮膚微濕（Damp）時立即塗抹保濕劑（B）能最有效地將水分鎖在角質層中。選項 A（熱水澡）會加速皮膚油脂流失，加劇乾燥，應改用溫水。選項 D（大量肥皂）會破壞皮脂膜，應減少使用或改用溫和清潔劑。選項 C（用力擦乾）會造成微細損傷並增加癢感，應改用毛巾輕壓（Pat dry）。這題考查的是 Basic Care 中針對特定年齡層（Geriatric）的舒適護理調整。
In older adults, decreased sebaceous gland secretion leads to fragile, dry skin that requires careful hydration management. Applying moisturizer while the skin is still damp after bathing effectively traps moisture in the stratum corneum, preventing further dryness and itching. This approach avoids the skin-damaging effects of hot water, vigorous rubbing, or excessive soap use.
美國 NCLEX 考題常將「減少洗澡頻率」作為老人皮膚護理的正確選項。台灣家屬常有「每天都要洗乾淨」的衛生迷思，護理師需解釋過度清潔對老化皮膚的傷害，並推廣正確的保濕觀念。