病人主訴失眠並要求開立安眠藥。護理師應先嘗試哪些非藥物護理措施？（選所有適合的）
A client is experiencing insomnia and requests a sleeping pill. Which non-pharmacological nursing intervention should be tried first? (Select all that apply.)
- AProvide a warm cup of decaffeinated tea or milk.✓ 正解提供一杯溫的無咖啡因茶或牛奶。
- BAdminister a back rub to promote relaxation.✓ 正解為病人進行背部按摩以促進放鬆。
- CDim the lights and reduce noise in the environment.✓ 正解調暗燈光並減少環境中的噪音。
- DDiscuss the client's daytime worries and anxieties.✓ 正解與客戶討論其白天的擔憂和焦慮。
- EPerform a vigorous range-of-motion exercise session.進行激烈的關節活動度運動課程。
在考慮藥物介入之前，護理師應優先執行促進睡眠環境與心理安寧的非藥物措施。這包含生理上的放鬆（溫熱無咖啡因飲料、背部按摩）與環境優化（光線與噪音控制）。心理層面上，失眠往往與焦慮有關，透過傾聽病人擔憂有助於降低壓力水平。溫牛奶含有色胺酸，是血清素的前驅物，有助於睡眠。反之，睡前進行劇烈運動（E）會提高心率與體溫，反而會讓神經系統過於興奮，導致更嚴重的失眠。這些介入措施體現了護理照護中「舒適」的本質。
Non-pharmacological interventions such as providing warm decaffeinated beverages, administering a back rub, dimming lights, and discussing anxieties promote relaxation and support the circadian rhythm. These measures address physiological and psychological barriers to sleep without the risks associated with medication. Vigorous exercise should be avoided near bedtime as it stimulates the nervous system and interferes with sleep onset.
美國護理實務強調「睡眠衛生（Sleep Hygiene）」教育，甚至在病歷中有專門的睡眠評估量表。台灣臨床環境因病房擁擠與家屬陪病，噪音控制（C）常是最大挑戰，護理師需投入更多精力在環境協調上。