— 健康促進與維護 · MEDIUM · SATA —
護理師指導第二型糖尿病病人關於足部照護。應包含哪些建議？（選所有適合的）
A nurse is teaching a client with Type 2 diabetes about foot care. Which instructions should be included? (Select all that apply.)
- AInspect feet daily for cuts, blisters, or swelling✓ 正解每日檢查雙腳是否有割傷、水泡或腫脹
- BWash feet daily with warm water and mild soap✓ 正解每日用溫水和溫和肥皂洗腳
- CApply lotion between the toes to keep skin soft在趾間塗抹乳液以保持皮膚柔軟
- DWear well-fitting, leather-based shoes✓ 正解穿著合腳的皮革鞋
- ETrim toenails straight across✓ 正解將趾甲平直修剪
— Explanation · 中文詳解 —
糖尿病足照護的核心目標是「預防傷口與感染」。由於糖尿病病人常合併周邊神經病變（Peripheral Neuropathy），對痛覺與溫度的感知遲鈍，微小傷口若未及時發現，極易惡化為潰瘍或壞疽。護理師應教導病人每日自我檢查足部細節，包括腳趾縫，並維持適當的清潔與保養。正確的鞋款選擇可避免壓迫導致的皮膚破損，平剪趾甲則能防止甲溝炎或崁甲。
Diabetic foot care includes daily inspection for injuries, washing with mild soap, wearing breathable footwear, and trimming toenails straight across to prevent ingrown nails. Lotion should not be applied between the toes, as excess moisture can promote fungal growth.
✦ 台美臨床差異
美國臨床護理中，對糖尿病足檢查的衛教極為重視，常建議病人若視力不佳，應使用鏡子反射或是請家屬協助檢查足底，這點在台灣臨床亦同，但針對「皮革製鞋」的建議在美國衛教中更為強調，因其透氣與保護性優於合成材質。