— 基本照護與舒適 · MEDIUM · MCQ —
護理師照護一位尿失禁的高齡病人。哪項干預措施對維護皮膚完整性最有效？
The nurse is caring for an elderly client with urinary incontinence. Which intervention is most effective in promoting skin integrity?
- ARestrict the client to the bed to prevent accidents.限制病人卧床以防止意外發生。
- BCleanse the skin with mild soap and water after each episode and apply a moisture barrier.✓ 正解每次發生尿失禁後，用溫和的肥皂和水清潔皮膚，並塗抹濕氣屏障膏。
- CLimit fluid intake to reduce the frequency of urination.限制液體攝取量以減少排尿頻率。
- DApply a thick layer of talcum powder to the perineal area.在會陰部塗抹厚層滑石粉。
— Explanation · 中文詳解 —
失禁相關性皮炎（IAD）的預防重點在於保持清潔與乾燥。每次失禁後應立即以中性清潔劑清洗並徹底擦乾，隨後塗抹皮膚屏障產品（如含鋅軟膏，B）。滑石粉（D）易結塊且刺激皮膚；限水（C）會導致尿液濃縮，反而更刺激皮膚且引起脫水；限制活動（A）會增加壓瘡風險並導致廢用症候群。
Preventing incontinence-associated dermatitis requires keeping the skin clean and dry to protect against irritation from urine. Cleansing with mild soap and water followed by a moisture barrier cream effectively shields the skin while maintaining hygiene. Other options such as restricting fluids or using talcum powder can worsen skin integrity or lead to dehydration, while immobility increases the risk of pressure injuries.
✦ 台美臨床差異
美國 NCLEX 強調「Barrier cream」的使用；台灣則常併用生理沖洗瓶進行會陰沖洗。