一名糖尿病病人正接受全靜脈營養 (TPN)。護理師應監測下列哪項以偵測 TPN 最常見的併發症？
A client with diabetes mellitus is receiving total parenteral nutrition (TPN). The nurse should monitor which of the following to detect the most common complication of TPN?
- AFingerstick glucose levels✓ 正解指尖血糖水平
- BBlood urea nitrogen (BUN)血尿素氮 (BUN)
- CDaily weights每日體重
- DSerum potassium levels血清鉀離子水平
全靜脈營養（Total Parenteral Nutrition, TPN）是透過靜脈輸注提供病人所有營養需求的治療方式，通常用於腸道功能不佳或無法經口進食的病人。TPN 溶液含有高濃度的葡萄糖、胺基酸、脂肪乳劑、電解質、維生素和微量元素，以滿足病人的能量和生長需求。 然而，TPN 治療也伴隨著潛在的併發症，其中最常見的代謝性併發症是高血糖（hyperglycemia）。特別是對於糖尿病病人，其胰島素分泌或作用已受損，面對 TPN 中大量葡萄糖的輸入，身體可能難以有效代謝，導致血糖迅速升高。未受控制的高血糖會增加感染風險、電解質失衡，甚至可能導致高滲透壓高血糖狀態（Hyperosmolar Hyperglycemic State, HHS），對病人造成嚴重危害。因此，護理師必須密切監測病人的血糖水平，以便及早發現並處理。指尖血糖監測（fingerstick glucose levels）是快速、簡便且直接偵測高血糖的有效方法，對於接受 TPN 的病人是常規且重要的監測項目。
TPN delivers concentrated dextrose and is most commonly complicated by hyperglycemia, especially in diabetic clients. Frequent fingerstick (point-of-care) glucose monitoring—commonly every 4-6 hours during initiation—is the most direct and timely method to detect hyperglycemia, which untreated can progress to hyperosmolar hyperglycemic state. Daily weights track fluid balance, potassium guards against refeeding syndrome, and BUN reflects renal function—all are important but secondary to glucose for the most common TPN complication.