— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師照顧長期使用皮質類固醇的病人。下列哪項發現應優先評估為潛在不良反應？
A nurse is caring for a client receiving long-term corticosteroid therapy. Which assessment finding should the nurse prioritize as a potential adverse effect?
- AMild facial acne輕微面部青春痘
- BReport of increased appetite主訴食慾增加
- CBlood glucose level of 185 mg/dL✓ 正解血糖值 185 mg/dL
- DWeight gain of 1 kg in one week一週內體重增加 1 kg
— Explanation · 中文詳解 —
長期使用皮質類固醇（Corticosteroids）會產生許多醫源性副作用。其中，糖皮質素會促進肝臟糖質新生（Gluconeogenesis）並產生胰島素阻抗，導致血糖升高（Steroid-induced hyperglycemia）。儘管體重增加與青春痘也是副作用，但高血糖（185 mg/dL）對代謝平衡的影響更具急性風險，需優先監控與評估。
Long-term use of corticosteroids produces many iatrogenic side effects. Glucocorticoids promote hepatic gluconeogenesis and induce insulin resistance, resulting in elevated blood glucose (steroid-induced hyperglycemia). Although weight gain and acne are also side effects, the impact of hyperglycemia (185 mg/dL) on metabolic balance poses a more acute risk and should be monitored and assessed as a priority.