護理師正在照護一名新診斷為周邊動脈疾病（PAD）的病人。為了降低併發症風險，護理師應在衛教計畫中包含哪項指導？
A nurse is caring for a client with a new diagnosis of peripheral arterial disease (PAD). Which instruction should the nurse include in the teaching plan to reduce the risk of complications?
- AApply a heating pad to the feet to improve circulation.使用熱敷墊於雙腳以促進循環。
- BElevate the legs above the level of the heart when resting.休息時將腿部抬高超過心臟水平。
- CWear tight-fitting socks to provide support to the lower legs.穿著緊身襪以提供小腿支撐。
- DInspect the feet daily for any red areas or skin breakdown.✓ 正解每日檢查雙腳是否有紅斑或皮膚破損。
周邊動脈疾病（PAD）的核心病理是動脈供血不足，導致末梢組織缺氧。這類病人常合併周邊神經病變，對溫度感官遲鈍且傷口癒合極慢。每日檢查足部（D）是預防潰瘍、感染甚至截肢最關鍵的自我照護。選項 A（熱敷）是禁忌，因為病人可能感覺不到燙而造成嚴重燒傷。選項 B（抬高下肢）會因重力關係進一步減少動脈灌流，PAD 病人通常應採取下肢下垂位（dependent position）以促進血流。選項 C（緊身襪）會壓迫動脈，加重缺血；PAD 不同於靜脈曲張，不適合使用壓迫性強的襪子。護理重點在於「保護、監測、促進灌流」。
Daily foot inspection is critical for clients with peripheral arterial disease (PAD) to detect early signs of injury or skin breakdown that may not heal properly due to poor circulation. Heating pads are contraindicated because decreased sensation increases the risk of thermal injury. Elevating legs above the heart reduces arterial blood flow, worsening ischemia, while tight clothing can further restrict circulation.
美國護理非常強調「Podiatry（足部醫療）」的早期轉介與跨團隊合作。在台灣，PAD 病人的衛教往往側重於藥物與戒菸，對於每日足部細節檢查（如使用長柄鏡）的結構化衛教在一般病房執行率仍有提升空間。