— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位第一型糖尿病病人接受 NPH 與速效胰島素混合治療。下列何種觀察顯示病人已學會正確注射觀念？
A client with type 1 diabetes is receiving NPH and regular insulin. Which nursing observation indicates effective client teaching regarding insulin administration?
- AThe client shakes the NPH vial vigorously before drawing病人在抽取前用力搖晃 NPH 胰島素瓶
- BThe client draws NPH insulin into the syringe first病人先將 NPH 胰島素吸入注射器
- CThe client draws regular insulin into the syringe first✓ 正解病人先將常規胰島素吸入注射器
- DThe client injects both insulins into the same site daily病人每天將兩種胰島素注射在同一部位
— Explanation · 中文詳解 —
混合胰島素時應遵守「清澈在先，混濁在後」原則。速效/短效為透明，中效 NPH 為混濁。先抽透明者可避免污染藥瓶。A 錯誤，需緩慢轉動而非劇烈搖晃，避免產生氣泡影響劑量。D 錯誤，需輪流注射部位以防脂肪增生。
When mixing insulins, the rule "clear before cloudy" applies. Rapid- or short-acting insulin is clear, while intermediate-acting NPH is cloudy. Drawing the clear insulin first prevents contamination of the regular insulin vial. Option A is incorrect because NPH should be gently rolled rather than vigorously shaken to avoid bubbles that affect dose accuracy. Option D is incorrect because injection sites must be rotated to prevent lipodystrophy.
✦ 台美臨床差異
胰島素混合原則全球通用，但現代多鼓勵使用預混型筆針，減少人工抽藥誤差。