一位 45 歲女性個案，無糖尿病病史，因大範圍腸道切除術後正接受中央靜脈全靜脈營養（TPN）。護理師依排程準備執行指尖血糖檢測。個案詢問：「我又沒有糖尿病，為什麼要驗血糖？」護理師應如何說明此評估的臨床理由？
A 45-year-old female client with no prior history of diabetes is receiving total parenteral nutrition (TPN) via a central line following a major bowel resection. The nurse arrives to perform a scheduled fingerstick blood glucose check. The client asks, "Why are you checking my blood sugar? I don't have diabetes." How should the nurse explain the rationale for this assessment?
- A"TPN damages the pancreas, which means your body permanently stops producing insulin.""全靜脈營養會損害胰臟，意味著您的身體將永久停止產生胰島素。"
- B"You may have contracted type 1 diabetes from a virus during your surgery.""您可能在手術期間因病毒感染而罹患第一型糖尿病。"
- C"The fingerstick stimulates pain receptors that distract from your post-operative bowel pain.""指尖採血會刺激痛覺受器，從而分散您術後腸道疼痛的注意力。"
- D"TPN contains a high concentration of glucose; even a healthy pancreas may not keep up with the load, putting you at risk for hyperglycemia."✓ 正解"全靜脈營養含有高濃度葡萄糖；即使胰臟功能正常，也可能無法負荷此負擔，使您面臨高血糖風險。"
全靜脈營養（TPN）為腸胃道功能受損且需長期營養支持的病人提供胺基酸、電解質與高濃度葡萄糖（dextrose 20-50%）。對接受 TPN 的病人，無論是否有糖尿病史，胰臟都可能無法應付持續的高糖負荷，因此醫療常規要求對「所有 TPN 病人」執行定期血糖監測（通常每 6 小時）。若出現顯著高血糖，可給予短效胰島素治療。其他選項：A 高糖負荷不會物理性破壞胰臟細胞；C 不是醫學上合理的疼痛轉移技巧；D 第一型糖尿病屬自體免疫疾病，非手術中由病毒急性傳染所致。
Total parenteral nutrition (TPN) provides amino acids, electrolytes, and high-concentration dextrose (20-50%) for clients with impaired gastrointestinal function who require prolonged nutritional support. For any client receiving TPN, regardless of diabetes history, the pancreas may be unable to handle the sustained glucose load; therefore, medical standards require routine blood glucose monitoring (usually every 6 hours) for all clients on TPN. If significant hyperglycemia occurs, short-acting insulin can be administered. Regarding the other options: A high glucose load does not physically damage pancreatic cells; C is not a medically valid pain distraction technique; D type 1 diabetes is an autoimmune disorder, not an acute viral infection transmitted during surgery.
「打 TPN 等同每六小時戳手指 (q6h check sugar) 加上打胰島素壓血糖 (Slide scale insulin)」。這在世界隨便一個重症與外科病房都是刻在牆壁上的照護常識套餐。