護理師正在照護一位有慢性腎臟病（CKD）且出現皮膚搔癢（pruritus）的病人。哪項介入措施最適合管理此症狀？（選所有適合的）
A nurse is caring for a client with chronic kidney disease (CKD) who is experiencing pruritus. Which intervention is MOST appropriate for managing this symptom? (Select all that apply.)
- AApply a moisturizing lotion after bathing✓ 正解沐浴後塗抹保濕乳液
- BEncourage the client to scratch the affected areas vigorously鼓勵客戶用力搔抓患處
- CAdminister an antihistamine as prescribed✓ 正解依處方給予抗組織胺
- DEducate the client about dietary restrictions for phosphorus✓ 正解教育客戶關於磷的饮食限制
- EProvide cool baths or showers✓ 正解提供冷水澡或淋浴
慢性腎臟病（CKD）引起的皮膚搔癢（uremic pruritus）主要源於尿毒素沉積、鈣磷失衡導致的繼發性副甲狀腺機能亢進，以及皮膚乾燥。治療策略應以改善皮膚屏障、降低發炎反應及控制生化數值為主。正確選項均能有效緩解症狀：保濕可改善乾燥；抗組織胺（antihistamine）可阻斷過敏反應；限制磷攝取可減少磷酸鈣結晶沉積於皮膚；冷水浴可減輕神經末梢敏感度。臨床上應優先採取非侵入性護理，並嚴禁搔抓以防繼發性感染。
Managing pruritus in chronic kidney disease involves applying moisturizing lotions to combat dryness, administering prescribed antihistamines, and educating the client on phosphorus-restricted diets to prevent calcium-phosphate crystal deposition. Additionally, providing cool baths can soothe the skin, while vigorous scratching must be avoided to prevent skin breakdown and infection.
在美國臨床，針對嚴重尿毒搔癢，除了上述措施，醫療團隊常會考慮使用加巴噴丁（Gabapentin）或紫外線光療（UVB phototherapy），這些在台灣雖然可用，但美國針對CKD相關神經病變型搔癢的用藥指引較為積極且常見。