— 藥理與非經腸給藥 · HARD · SATA —
護理師照護一位長期接受全靜脈營養（TPN）的病人。下列哪些發現暗示病人可能出現併發症？（選所有適合的）
A nurse is caring for a client receiving long-term parenteral nutrition. Which findings suggest that the client may be experiencing complications? (Select all that apply.)
- ABlood glucose level of 210 mg/dL✓ 正解血糖濃度為 210 mg/dL
- BSerum potassium level of 3.2 mEq/L✓ 正解血清鉀濃度為 3.2 mEq/L
- CClient reports sudden onset of dyspnea and chest pain✓ 正解病人主訴突然發作的呼吸困難和胸痛
- DSite redness and purulent drainage at the CVAD✓ 正解中心靜脈導管部位紅腫且有膿性分泌物
- EWeight gain of 1.5 kg in 24 hours✓ 正解24小時內體重增加 1.5 kg
— Explanation · 中文詳解 —
TPN 併發症廣泛，包括高血糖（高滲透壓影響）、電解質失衡（低鉀常見於代謝加速）、導管相關感染（紅腫膿液）、空氣栓塞（呼吸困難與胸痛）及因輸液過速導致的水分過載。每一項數據與臨床表現均需警覺並立即處理。
Complications of TPN are wide-ranging, including hyperglycemia (due to high osmolality), electrolyte imbalance (hypokalemia is common due to accelerated metabolism), catheter-related infection (redness, swelling, purulent drainage), air embolism (dyspnea and chest pain), and fluid overload from rapid infusion. Every laboratory value and clinical finding requires vigilance and immediate management.
✦ 台美臨床差異
美國護理師常需負責 TPN 的配製與處方調整建議，台灣則多由藥師配置，護理師監測臨床指標。