護理師正在教導一位有草酸鈣腎結石病史的個案。應包含哪項飲食指導以預防復發？
The nurse is educating a client with a history of calcium oxalate kidney stones. Which dietary instruction should be included to prevent recurrence?
- AIncrease intake of spinach and rhubarb.增加菠菜和大黃的攝取
- BEliminate all calcium-rich foods from the diet.從飲食中完全排除所有富含鈣質的食物
- CIncrease sodium intake to promote calcium excretion.增加鈉攝取以促進鈣排泄
- DMaintain adequate fluid intake to produce 2 liters of urine daily.✓ 正解維持充足液體攝取，以每日產生 2 公升尿液
本題考察護理師對於預防草酸鈣腎結石復發的飲食衛教知識。草酸鈣結石是最常見的腎結石類型，其形成與飲食習慣有密切關係。護理師在衛教時，需提供實用且有科學依據的飲食建議，以幫助個案有效降低結石復發的風險。 正確答案 D 強調維持充足的液體攝取，目標是每日尿量達到 2 公升。這是預防所有類型腎結石，特別是草酸鈣結石復發最重要的措施。充足的液體攝取可以稀釋尿液中的結石形成物質，降低其濃度，從而減少結晶和結石形成的機會。護理師應鼓勵個案多喝水，並監測尿量。 其他選項的飲食建議，例如完全限制鈣質或增加高草酸食物攝取，則可能適得其反或對健康造成其他不利影響，因此為錯誤答案。
This question assesses the nurse's knowledge of dietary teaching to prevent the recurrence of calcium oxalate kidney stones. Calcium oxalate stones are the most common type of kidney stones, and their formation is closely related to dietary habits. The nurse should provide practical, evidence-based dietary recommendations to help clients effectively lower the risk of recurrence. The correct answer D emphasizes maintaining adequate fluid intake with a goal of 2 liters of urine daily. This is the single most important measure to prevent recurrence of all types of kidney stones, particularly calcium oxalate stones. Adequate fluid intake dilutes the stone-forming substances in the urine, lowering their concentration and reducing the chance of crystal and stone formation. The nurse should encourage adequate water intake and monitor urine output. Other dietary recommendations — such as completely restricting calcium or increasing intake of high-oxalate foods — may be counterproductive or have other adverse effects, so they are incorrect.
台美兩地對於預防草酸鈣腎結石的飲食衛教原則是高度一致的。核心建議都包含充足的液體攝取（每日尿量達 2 公升）、適量攝取鈣質（不需嚴格限制）、限制高草酸食物、減少鈉和動物性蛋白質的攝取。護理師在提供衛教時，會強調這些飲食調整的重要性，並鼓勵個案與醫師或營養師共同制定個人化的飲食計畫。