護理師照顧一位有癲癇病史的病人，下列哪些護理措施能預防發作時的傷害？（選所有適合的）
A nurse is caring for a client with a history of seizures. Which interventions should the nurse include in the plan of care to prevent injury during a seizure? (Select all that apply.)
- APad the side rails of the bed✓ 正解在床欄上鋪設軟墊
- BKeep a tongue blade at the bedside在床邊備妥壓舌板
- CClear the area of hard or sharp objects✓ 正解清除硬物或尖銳物品
- DPlace the client in a side-lying position✓ 正解將病人置於側臥姿勢
- EApply soft restraints to prevent flailing施加軟性約束帶以防止肢體揮舞
癲癇發作時的護理重點為保護頭部與呼吸道。保護欄杆可避免碰傷；移除尖銳物減少外傷；側臥姿（recovery position）可防止嘔吐物吸入。壓舌板已證實會傷害牙齒或造成呼吸道阻塞，故嚴禁使用。束縛帶會導致肌肉拉傷，亦不建議使用。
To prevent injury during a seizure, the nurse should pad the side rails to protect against blunt force trauma and clear the area of hard or sharp objects to avoid lacerations. Placing the client in a side-lying position is crucial to maintain airway patency and facilitate drainage of secretions, preventing aspiration. Inserting objects like tongue blades or applying restraints is contraindicated as they can cause physical harm or increase agitation.
台美臨床指引皆已廢除口腔放置異物。美國護理單位多設有癲癇預防套餐，台灣則視病房屬性加強床欄保護措施。