— 生理適應 · EASY · MCQ —
一位第一型糖尿病病人意識喪失，血糖 35 mg/dL。病人無法吞嚥，護理師應採取何項行動？
A client with type 1 diabetes mellitus is found unconscious. Blood glucose is 35 mg/dL. The client is not alert enough to swallow. What should the nurse do?
- APlace oral glucose gel in the cheek pocket將口服葡萄糖凝膠置於頰囊
- BGive a cup of orange juice with sugar給予一杯加糖的柳橙汁
- CAdminister regular insulin via IV經靜脈給予常規胰島素
- DAdminister 50% dextrose IV push✓ 正解經靜脈推注50%葡萄糖
— Explanation · 中文詳解 —
病人意識不清且有誤吸風險時，絕對禁止餵食。低血糖昏迷時需立即給予靜脈推注 50% Dextrose，以快速提升血糖濃度。口服葡萄糖凝膠僅適用於意識清醒者；胰島素會加劇低血糖；橘子汁亦有誤吸可能，皆不適宜。
When the client is unconscious and at risk for aspiration, oral intake is strictly contraindicated. In hypoglycemic coma, IV push of 50% dextrose must be given immediately to rapidly raise the blood glucose level. Oral glucose gel is appropriate only for conscious clients; insulin would worsen hypoglycemia; and orange juice carries a high aspiration risk—all are inappropriate.
✦ 台美臨床差異
在美國部分地區，受訓過的護理師可於急診室或病房直接給予 D50；台灣此類高濃度藥物多需醫師執行或嚴格遵循醫囑。