一位糖尿病酮酸中毒（DKA）病人入院，哪項護理措施最關鍵？
A client is admitted with diabetic ketoacidosis (DKA). Which nursing action is most critical?
- AAdministering subcutaneous insulin給予皮下注射胰島素
- BProviding high-calorie nutritional supplements提供高熱量營養補充品
- CInitiating an isotonic IV fluid bolus✓ 正解開始給予等張靜脈輸液推注
- DMonitoring for hypoglycemia監測低血糖
糖尿病酮酸中毒（DKA）是一種危及生命的急性併發症。其病理機制為胰島素缺乏導致高血糖、滲透性利尿與嚴重脫水。護理優先順序依循 ABC 原則（Circulation），首要任務是恢復血液循環體積以改善組織灌流，並透過靜脈輸液稀釋血糖、增加腎臟排除葡萄糖的能力。在循環體積未獲得初步穩定前，給予胰島素可能導致低血鉀或循環衰竭。
Diabetic ketoacidosis (DKA) is a life-threatening acute complication. Its pathophysiology involves insulin deficiency leading to hyperglycemia, osmotic diuresis, and severe dehydration. Nursing priorities follow the ABC principle (Circulation): the primary task is to restore circulating blood volume to improve tissue perfusion and, through IV fluids, to dilute blood glucose and enhance renal excretion of glucose. Administering insulin before circulating volume is initially stabilized can lead to hypokalemia or circulatory collapse.
在美國臨床，DKA 的處理通常有嚴格的 Protocol（例如由醫師開立的 Bolus 劑量與後續維持液速度）。護理師需具備根據血糖監測結果調整胰島素滴速的權限（依據醫囑範圍）。