— 藥理與非經腸給藥 · HARD · MCQ —
病人經由中央靜脈導管接受全靜脈營養（TPN），下列何者為護理師最高優先級的措施？
A client is receiving total parenteral nutrition (TPN) via a central venous catheter. Which intervention is the highest priority?
- AMonitor blood glucose levels every 6 hours每 6 小時監測血糖水平
- BVerify the TPN infusion rate using an electronic infusion pump✓ 正解使用電子輸注泵確認全靜脈營養 (TPN) 的輸注速率
- CWeigh the client daily每日稱量病人體重
- DChange the dressing every 48 hours每 48 小時更換敷料
— Explanation · 中文詳解 —
TPN 溶液成分複雜且含高濃度葡萄糖，輸注速度錯誤極易造成嚴重代謝併發症或高血糖危象。雖然血糖監測與體重管理均重要，但確保輸注速率的精確性是預防急性醫源性傷害的首要任務。敷料更換頻率通常遵照機構指引，非最優先。
TPN solutions have a complex composition that includes high-concentration dextrose, and an incorrect infusion rate can readily cause severe metabolic complications or hyperglycemic crisis. Although blood glucose monitoring and weight management are also important, ensuring the accuracy of the infusion rate is the foremost task in preventing acute iatrogenic harm. Dressing change frequency follows facility policy and is not the highest priority.
✦ 台美臨床差異
兩地皆高度仰賴幫浦控制，美國對於 TPN 輸注流程有極嚴格的雙人核對（Double-check）規定。