# 一位老年人意識混亂，試圖在無人協助下下床。哪項措施最能降低跌倒風險？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=394163&lang=zh-tw  
> language: zh-TW  
> subject: Accident/Error/Injury Prevention  
> category: BCC

## 題目

一位老年人意識混亂，試圖在無人協助下下床。哪項措施最能降低跌倒風險？

## 選項

1. 將床保持在最高位置以便於觀察。
2. 保持房間黑暗以便個案入睡。
3. 將叫人鈴放在房間另一端以鼓勵活動。
4. 保持床在低位，啟動離床警報器，並將所需物品放在伸手可及之處。 **✔ 正確答案**

**正確答案: 4**

## 解析

預防跌倒包括低位床、必要時使用警報器、通道暢通、防滑鞋、充足照明及物品在伸手可及之處。高床、黑暗及無法觸及的叫人鈴會增加跌倒風險。意識混亂需要主動的安全措施。

## 深入解析

臨床判斷
預防跌倒是在個案跌倒前調整環境。

記憶提示
低位床、燈光、警報器、叫人鈴。

## 臨床情境

臨床實務指引
防跌措施應根據認知、活動能力、藥物、如廁需求及過去跌倒史進行個別化設計。

注意
約束不是常規的防跌工具。

## 重要概念

- **跌倒風險** — 基於個人及環境因素而發生跌倒的可能性。
- **離床警報器** — 當個案試圖起身時會警示工作人員的裝置。
- **環境安全** — 減少照護環境中的危險因子。

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