— 生理適應 · MEDIUM · MCQ —
護理師照護一位新診斷的第 1 型糖尿病病人，哪項發現需要立即介入？
A nurse is caring for a client with newly diagnosed type 1 diabetes mellitus. Which finding requires immediate intervention?
- AFasting blood glucose of 150 mg/dL空腹血糖 150 mg/dL
- BRandom blood glucose of 250 mg/dL隨機血糖 250 mg/dL
- CHemoglobin A1c of 8.5%糖化血色素 8.5%
- DBlood glucose of 400 mg/dL with ketones in urine✓ 正解血糖 400 mg/dL 且尿液中有酮體
— Explanation · 中文詳解 —
第 1 型糖尿病病人血糖 400 mg/dL 伴隨尿酮，是糖尿病酮酸中毒 (DKA) 的警訊。DKA 是危及生命的緊急狀況，需要立即輸液、胰島素和電解質補充。其他選項的血糖值雖高，但未伴隨酮體，非立即危險。
A blood glucose of 400 mg/dL accompanied by urine ketones in a client with type 1 diabetes is a warning sign of diabetic ketoacidosis (DKA). DKA is a life-threatening emergency requiring immediate fluid resuscitation, insulin therapy, and electrolyte replacement. Although the other options also show elevated glucose values, they are not accompanied by ketones and do not pose an immediate danger.
✦ 台美臨床差異
美國糖尿病衛教師 (CDE) 角色重要，提供病人教育；台灣護理師在門診和病房提供基本衛教，但專科衛教師資源較有限。