— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師照顧一位正在接受全靜脈營養（PN）的病人。為預防併發症，下列哪些評估是必須的？（選所有適合的）
A nurse is caring for a client receiving parenteral nutrition (PN). Which nursing assessments are essential to prevent complications? (Select all that apply.)
- AMonitor blood glucose every 6 hours✓ 正解每 6 小時監測血糖
- BWeigh the client daily✓ 正解每日稱量體重
- CCheck the IV site for signs of phlebitis✓ 正解檢查靜脈注射部位是否有靜脈炎跡象
- DReview daily liver function tests檢視每日肝功能檢驗
- EAssess intake and output strictly✓ 正解嚴格評估出入量
— Explanation · 中文詳解 —
全靜脈營養含有高濃度葡萄糖，容易導致高血糖與滲透壓不平衡。監測血糖可防止高滲透壓高血糖狀態；每日體重可評估水分平衡；檢查注射部位可預防感染與靜脈炎。精確計算 I/O 是評估體液負荷的關鍵。肝功能雖需監測，但非每日例行核心，且選項 D 提到的頻率過高。
PN contains high glucose concentrations, predisposing to hyperglycemia and osmotic imbalance. Glucose monitoring prevents hyperosmolar hyperglycemic states; daily weights assess fluid balance; IV site checks prevent infection and phlebitis. Strict I/O is key for fluid balance. Liver function is monitored but not daily as a core routine; option D's stated frequency is too high.
✦ 台美臨床差異
PN 處方在兩地多由藥師與營養師協調，美國護理師常需參與小組會議，台灣則由醫師與營養小組主導。