— 降低風險 · MEDIUM · SATA —
護理師對第一型糖尿病病人進行足部護理指導，下列哪些敘述顯示病人需要進一步衛教？（選所有適合的）
A nurse is teaching a client with type 1 diabetes about foot care. Which statements by the client indicate a need for further teaching? (Select all that apply.)
- AI will soak my feet in hot water every night to keep them soft✓ 正解我會每晚用熱水泡腳以保持柔軟
- BI will inspect my feet daily for blisters or redness我會每天檢查雙腳是否有水泡或紅腫
- CI will use a heating pad to warm my feet during winter✓ 正解冬天我會使用暖寶寶來溫暖雙腳
- DI will wear well-fitted, closed-toe shoes at all times我會隨時穿著合腳且包覆鞋頭的鞋子
- EI will cut my toenails straight across to prevent ingrown nails我會將趾甲平直修剪以防嵌甲
— Explanation · 中文詳解 —
糖尿病足部護理的核心是預防皮膚破損與感染。由於糖尿病周邊神經病變（Peripheral Neuropathy），病人對溫度和痛覺的感知能力減弱，極易發生低溫燙傷或因未察覺的小傷口引發嚴重的蜂窩性組織炎甚至截肢。正確的指導應強調保養但避免過度刺激與熱源。選項 A 和 C 皆涉及熱源與浸潤風險，屬於需要重新教育的錯誤認知。
Soaking feet and using heating pads are unsafe because diabetic neuropathy reduces sensation, increasing the risk of burns and skin breakdown. These actions require further teaching to prevent injury and infection.
✦ 台美臨床差異
美國臨床極度強調糖尿病足部評估的細節，護理師需在衛教時確認病人有無『鏡子』檢查足底。台灣臨床衛教常由護理師執行，美國則更強調病人自我管理（Self-management）能力的賦權。