— 生理適應 · MEDIUM · MCQ —
一名第一型糖尿病患血糖 450 mg/dL 且呼吸帶有水果味，護理師應預期首要介入為何？
A client with type 1 diabetes mellitus presents with a blood glucose level of 450 mg/dL and fruity-smelling breath. Which intervention should the nurse anticipate first?
- AAdministering long-acting insulin subcutaneously皮下注射長效胰島素
- BAdministering oral glucose gel給予口服葡萄糖凝膠
- CInitiating intravenous normal saline infusion✓ 正解開始靜脈輸注正常食鹽水
- DObtaining a clean-catch urine sample取得清潔中段尿樣本
— Explanation · 中文詳解 —
此個案呈現糖尿病酮酸中毒（DKA）徵象，高血糖與呼吸果香味為關鍵特徵。首要治療目標是復甦血容積，緩解組織灌流不足，因此需快速給予靜脈輸液（通常為生理食鹽水）。後續才進行胰島素治療，避免初期即給予胰島素導致電解質失衡。
This client shows signs of diabetic ketoacidosis (DKA), with hyperglycemia and fruity-smelling breath as key features. The primary treatment goal is to restore intravascular volume and relieve tissue hypoperfusion, so rapid administration of IV fluids (usually normal saline) is required. Insulin therapy follows, since giving insulin first can produce electrolyte imbalance.
✦ 台美臨床差異
美台對 DKA 處置流程相似，均強調先補水後補電解質與胰島素，台灣護理師較少自主決定輸液速率。