對於接受全靜脈營養（PN）的病人，下列哪些評估最重要？（選所有適合的）

核心概念：全靜脈營養（Total Parenteral Nutrition, TPN）的護理監測。 為何正確答案對： A. 每日體重測量（Monitor daily weights）是評估 TPN 治療效果和水分平衡最敏感且重要的指標。體重快速增加可能表示液體滯留，而體重減輕則可能意味著營養攝取不足或代謝異常。 B. 血糖監測（Check blood glucose levels every 6 hours）至關重要，因為 TPN 含有高濃度葡萄糖，容易引起高血糖（Hyperglycemia），甚至誘發高滲透壓非酮性高血糖狀態（HHS）。血糖監測有助於及時調整 TPN 配方或給藥。 C. 導管相關感染（Catheter-related infection）是 TPN 的嚴重併發症，因此嚴密監測穿刺部位（Site）是否有紅、腫、熱、痛、分泌物等感染跡象是必須的。 D. 嚴格記錄出入量（Measure intake and output）有助於評估病人的水份平衡狀態，與每日體重一同監測，可更全面地了解體液狀況。 為何其他選項錯： E. 檢測尿中酮體（Check for urinary ketone levels）主要用於評估糖尿病酮酸中毒（DKA）或飢餓狀態下的脂肪分解，對於 TPN 病人，雖然需監測血糖，但尿酮並非最優先或常規的監測項目，除非有特定臨床指徵。

Core concept: nursing monitoring for Total Parenteral Nutrition (TPN). Why the correct answers are right: A. Monitoring daily weights is the most sensitive and important indicator for assessing the effectiveness of TPN therapy and fluid balance. Rapid weight gain may indicate fluid retention, while weight loss may signal inadequate nutritional intake or metabolic abnormalities. B. Checking blood glucose every 6 hours is critical because TPN contains a high concentration of dextrose, which readily causes hyperglycemia and can even precipitate hyperosmolar hyperglycemic state (HHS). Glucose monitoring allows timely adjustment of the TPN formula or medication. C. Catheter-related infection is a serious complication of TPN, so close monitoring of the insertion site for signs of infection (redness, swelling, warmth, pain, drainage) is essential. D. Strict intake and output measurement helps assess the client's fluid balance status; combined with daily weights, it provides a comprehensive picture of fluid status. Why the other options are wrong: E. Checking urinary ketone levels is primarily used to evaluate diabetic ketoacidosis (DKA) or fat breakdown during starvation. For TPN clients, although glucose monitoring is needed, urine ketones are not the most important or routine monitoring item unless specific clinical indications exist.