— 基本照護與舒適 · MEDIUM · MCQ —
護理師照顧一位尿失禁的病人，哪項介入措施是適當的？
A nurse is caring for a client with urinary incontinence. Which intervention is appropriate?
- AUse diapers at all times to keep the skin dry始終使用尿布以保持皮膚乾燥
- BEncourage bladder training exercises✓ 正解鼓勵膀胱訓練運動
- CLimit fluid intake to prevent accidents限制水分攝取以防止意外
- DInsert an indwelling catheter as a first-line treatment將留置導尿管作為第一線治療
— Explanation · 中文詳解 —
膀胱訓練（如凱格爾運動、定時解尿）是治療尿失禁的標準護理措施。限制水分會導致尿液濃縮，反而刺激膀胱增加失禁發生率；導尿管雖能保持乾燥，但極易導致導管相關泌尿道感染（CAUTI），不應作為失禁的第一線處理；長期依賴尿布會增加皮膚過敏與壓瘡風險，應儘量進行訓練。
Bladder training exercises, such as Kegel exercises and scheduled voiding, are appropriate interventions to strengthen sphincter control and manage urinary incontinence. Limiting fluids can irritate the bladder with concentrated urine, while indwelling catheters pose a high risk for infection and should not be first-line treatments. Frequent diaper changes are preferable to constant use, but behavioral training is the preferred long-term strategy.
✦ 台美臨床差異
台灣醫院對預防 CAUTI 的管控日益嚴格，但在安養機構中，導尿管的使用有時仍被視為照顧者的方便選擇，需教育改善。