— 基本照護與舒適 · HARD · MCQ —
護理師照顧一位有認知功能障礙的高齡病人，下列何者對於促進睡眠最有效？
A nurse is caring for an older adult with cognitive impairment. Which intervention is most effective for promoting sleep?
- AKeep the light on in the room to reduce disorientation保持房間燈光亮起以減少定向障礙
- BEncourage napping during the day to prevent fatigue鼓勵白天小睡以預防疲勞
- CMaintain a consistent bedtime routine each night✓ 正解每晚維持一致的就寢常規
- DAdminister a hypnotic medication at 8 PM於晚上 8 點施用催眠藥物
— Explanation · 中文詳解 —
規律的作息（Bedtime routine）能為認知障礙病人提供預期性與安全感，有效調節生理時鐘。藥物易引起跌倒或混亂惡化，不應為首選；日間過度小睡會干擾夜間睡眠；開燈則會抑制褪黑激素分泌，影響睡眠品質，對於減少夜間混亂應透過環境安撫，而非光線刺激。
Maintaining a consistent bedtime routine provides predictability and security for clients with cognitive impairment, helping to regulate their circadian rhythm. Keeping lights on suppresses melatonin production and disrupts sleep cycles, while daytime napping can reduce the sleep drive at night. Sedative medications are not the first-line intervention due to the increased risk of falls and delirium in older adults.
✦ 台美臨床差異
美國護理界極力推廣 'Non-pharmacological interventions' 作為首選（如音樂治療、環境調整），台灣在臨床依賴藥物的比例仍相對偏高。