— 降低風險 · MEDIUM · SATA —
護理師指導一位新造口病人關於造口照護的重點，應包含下列哪些內容？（選所有適合的）
A nurse is teaching a client who has a new colostomy. Which instructions regarding stoma care should be included? (Select all that apply.)
- ACleanse the skin around the stoma with warm water✓ 正解用溫水清潔造口周圍皮膚
- BCut the skin barrier 1/8 inch larger than the stoma✓ 正解將皮膚保護膜剪裁得比造口大 1/8 英吋
- CExpect the stoma to appear pale or dusky in color預期造口顏色呈蒼白或暗色
- DEmpty the pouch when it is one-third to one-half full✓ 正解當集便袋裝至三分之一到一半時排空
- EApply a skin sealant before attaching the barrier在貼上保護膜前塗抹皮膚密封劑
— Explanation · 中文詳解 —
造口照護核心在於皮膚保護與評估血流。水溫清潔足夠，避免化學刺激。底盤裁切應比造口大一點（約 0.3 公分），避免勒傷造口。袋子容量過重會導致滲漏，故 1/3 至 1/2 滿即清空。顏色應為鮮紅至粉紅，蒼白或灰暗暗示缺血，必須立即通報。
Stoma care involves cleansing the peristomal skin with warm water to avoid irritation and cutting the skin barrier approximately 1/8 inch larger than the stoma to prevent constriction and tissue damage. The pouch should be emptied when one-third to one-half full to prevent excessive weight from compromising the seal, and the stoma should be monitored for healthy pink-red coloration rather than pale or dusky hues.
✦ 台美臨床差異
台灣造口護理師（WOCN）角色專業，美國護理師則更強調病人的自我護理與居家衛教系統性。