一位病人正透過中心靜脈導管接受全靜脈營養（TPN）。應執行哪些護理措施？（選所有適合的）
A client is receiving Total Parenteral Nutrition (TPN) via a central line. Which nursing interventions should be implemented? (Select all that apply.)
- AChange the TPN tubing and filter every 24 hours✓ 正解每24小時更換TPN管路與過濾器
- BCheck blood glucose levels every 4 to 6 hours✓ 正解每4至6小時檢查血糖水平
- CAdminister IV antibiotics through the same TPN line通過同一條TPN導管給予靜脈抗生素
- DInfuse 10% dextrose in water if the TPN bag runs out early✓ 正解若TPN袋提前用完，給予10%葡萄糖水輸注
- ESpeed up the infusion rate if the schedule falls behind若輸注進度落後，加快輸注速率
TPN 是高風險的靜脈治療。核心護理重點在於：預防感染、監測血糖及維持輸注穩定。TPN 含有高濃度的葡萄糖，是細菌生長的優良培養基，因此每 24 小時必須更換輸液管路（A）。高糖負荷易導致高血糖，需每 4-6 小時監測血糖（B）。若 TPN 突然中斷，病人可能發生反彈性低血糖，故若新藥袋未到，應暫時以 10% 葡萄糖液（D10W）維持輸注（D）。選項 C 錯誤：TPN 管路應專用，不可隨意併用其他藥物以防沉澱或感染。選項 E 錯誤：TPN 絕對禁止補追進度，否則會造成滲透壓急劇變化和高血糖危象。這題測驗護理師對高警訊藥物管理的綜合能力。
TPN is a high-risk intravenous therapy. The core nursing priorities are infection prevention, blood glucose monitoring, and maintaining stable infusion. TPN contains a high concentration of glucose and is an excellent growth medium for bacteria, so the IV tubing must be changed every 24 hours (A). The high glucose load easily causes hyperglycemia, requiring blood glucose monitoring every 4-6 hours (B). If TPN is suddenly interrupted, the client may develop rebound hypoglycemia, so if the next bag has not arrived, 10% dextrose in water (D10W) should be infused temporarily to maintain glucose delivery (D). Option C is incorrect: the TPN line should be dedicated and other medications should not be infused through it, to prevent precipitation or infection. Option E is incorrect: it is absolutely prohibited to 'catch up' on a TPN schedule, as this would cause sudden osmotic changes and a hyperglycemic crisis. This item tests the nurse's comprehensive management of high-alert medications.
在美國，TPN 的更換時間與血糖監測頻率有非常明確的醫院 Standard Operating Procedures (SOP)；台灣臨床上對於管路更換有時會依據不同醫院感染控制委員會的規定（24 或 72 小時不等），但在 NCLEX 考試中，含有脂肪乳劑的 TPN 必須 24 小時更換。