病人因糖尿病酮酸中毒（DKA）入院。在液體復甦初期，哪項護理措施是必要的？
A client is admitted with diabetic ketoacidosis (DKA). Which nursing action is essential during the initial phase of fluid resuscitation?
- AProvide a high-calorie diet to prevent hypoglycemia提供高熱量飲食以預防低血糖
- BAdminister potassium chloride IV push靜脈推注氯化鉀
- CAdminister 5% dextrose in water intravenously靜脈注射 5% 葡萄糖水
- DInitiate an infusion of 0.9% normal saline✓ 正解開始輸注 0.9% 生理食鹽水
糖尿病酮酸中毒（DKA）的核心病理生理為胰島素缺乏導致高血糖、滲透性利尿及嚴重脫水。液體復甦是治療的第一優先步驟，目的是恢復血管內容量、組織灌流並促進腎臟排泄葡萄糖。在初期階段，使用 0.9% 等張生理食鹽水（Normal Saline）可有效擴張細胞外液容積。鉀離子調節雖重要，但需在確保尿量與腎功能後才進行；而高熱量飲食或含糖點滴在初期高血糖狀況下均為禁忌。
The core pathophysiology of diabetic ketoacidosis (DKA) is insulin deficiency causing hyperglycemia, osmotic diuresis, and severe dehydration. Fluid resuscitation is the first priority of treatment, intended to restore intravascular volume, tissue perfusion, and renal glucose excretion. In the initial phase, isotonic 0.9% normal saline effectively expands the extracellular fluid volume. Potassium management is important but should be initiated only after urine output and renal function are confirmed; high-calorie diets and dextrose-containing IV fluids are contraindicated during the initial hyperglycemic phase.