一位患有第一型糖尿病的病人血糖為 450 mg/dL，出現庫斯莫爾氏呼吸（Kussmaul respirations）與水果味口氣。護理師應優先採取何種行動？
A client with type 1 diabetes mellitus presents with a blood glucose level of 450 mg/dL, Kussmaul respirations, and fruity breath. Which nursing action is priority?
- APrepare for oral glucose administration準備給予口服葡萄糖
- BInitiate an intravenous infusion of 0.9% normal saline✓ 正解開始輸注 0.9% 生理食鹽水
- CObtain a bedside capillary blood glucose reading取得床邊毛細血管血糖讀數
- DAdminister subcutaneous regular insulin給予皮下注射常規胰島素
此病人呈現糖尿病酮酸中毒（DKA）徵象，高血糖、庫斯莫爾呼吸與水果味口氣均為典型臨床表徵。生理適應上，細胞外液體流失與酸中毒是危及生命的主因，因此首要任務是啟動靜脈輸液以恢復循環容量與腎臟灌流，穩定生命跡象後再進行胰島素治療。
This client presents with signs of diabetic ketoacidosis (DKA); hyperglycemia, Kussmaul respirations, and fruity breath are all classic clinical features. From a physiological adaptation perspective, extracellular fluid loss and acidosis are the main life-threatening problems, so the first priority is to initiate intravenous fluid therapy to restore circulating volume and renal perfusion before starting insulin therapy after vital signs are stabilized.
美國護理師常依據 DKA 處理指引（Protocol）立即掛上生理食鹽水，台灣通常需確認醫師醫囑後再執行，但緊急狀況下會啟動 ALS 流程。