— 生理適應 · EASY · MCQ —
一位糖尿病患被發現意識不清，血糖值為 45 mg/dL。護理師應優先採取哪項措施？
A client with diabetes mellitus is found unconscious with a blood glucose level of 45 mg/dL. Which action should the nurse take first?
- AProvide a glass of orange juice提供一杯柳橙汁
- BAdminister subcutaneous insulin給予皮下注射胰島素
- CAdminister 50% dextrose intravenously✓ 正解靜脈注射 50% 葡萄糖
- DPerform a neurological assessment進行神經學評估
— Explanation · 中文詳解 —
對於意識不清的低血糖病人，無法經口進食，靜脈注射 50% 葡萄糖是處理嚴重低血糖的標準緊急處置，能迅速提升血糖以恢復意識。給予口服果汁恐導致嗆咳與吸入性肺炎，胰島素會加重低血糖，神經評估應在穩定生命徵象後執行。
In an unconscious diabetic with severe hypoglycemia (BG 45 mg/dL), the priority is rapid IV administration of 25-50 mL of 50% dextrose (or IM/SC glucagon if no IV access). Oral glucose sources are contraindicated because of aspiration risk. Insulin would worsen hypoglycemia. Neurologic assessment follows stabilization of glucose.
✦ 台美臨床差異
台美均遵循 ACLS 處理低血糖準則，惟美國護理師常依 protocol 直接給藥，台灣常見需醫師開立口頭醫囑。