一位術後第一天的病人在病房反應入睡困難。護理師應首先實施哪項非藥物介入措施？
A nurse is caring for a client who is post-operative day 1 and reports difficulty sleeping in the hospital. Which non-pharmacological intervention should the nurse implement first?
- AEncourage the client to drink a cup of hot caffeinated tea.鼓勵病人喝一杯熱的含咖啡因茶
- BCluster nursing activities to provide uninterrupted rest periods.集中護理活動以提供不受打擾的休息時間
- CAdminister a prescribed PRN sedative-hypnotic medication.給予處方備用鎮靜催眠藥物
- DDim the lights and close the client's door to reduce noise.✓ 正解調暗燈光並關閉病人房門以降低噪音
睡眠衛生的首要原則是「環境控制」。對於術後病人，醫院的環境噪音（儀器報警、工作人員交談）與光線是睡眠剝奪的主要來源。根據護理程序，應先嘗試最簡單且無副作用的介入。選項 D（調暗燈光、關門）能立即減少環境刺激，建立適合睡眠的微環境，是首選動作。選項 B（集中護理活動）雖能提供完整的休息區間，但在病人已經在抱怨入睡困難的當下，改變即時環境的效果最直接。選項 C 是藥物介入，NCLEX 傾向於先執行非侵入性/非藥物措施；選項 A 的咖啡因會抑制睡眠。有效的護理應包含詢問病人的睡眠習慣（如枕頭高度），並儘可能在臨床安全範圍內予以配合。安全上，關門時需確保呼叫鈴在手邊且監視器可運作。
The priority non-pharmacological intervention for sleep disturbance is modifying the environment to reduce stimuli. Dimming lights and closing the door directly address common hospital barriers to sleep, such as noise and light exposure. While clustering care is beneficial for long-term rest, it does not immediately resolve the current difficulty falling asleep, and caffeine would further inhibit sleep.
美國醫院普遍實行「Quiet Hours」政策，並嚴格限制走廊談話聲；台灣病房因多為多人房（健保房），環境控制較具挑戰性，護理師常需額外協調陪病家屬的行為（如關電視聲）來達到類似效果。