護理師照護一位經由中心靜脈導管接受全靜脈營養（TPN）的病人。護理師應執行哪些處置？（選所有適合的）
The nurse is caring for a client receiving total parenteral nutrition (TPN) via a central venous catheter. Which interventions should the nurse implement? (Select all that apply.)
- ACheck the client's blood glucose level every 4 to 6 hours.✓ 正解每 4 至 6 小時檢查病人的血糖水平
- BChange the TPN infusion tubing every 24 hours.✓ 正解每 24 小時更換全靜脈營養輸注管路
- CIncrease the infusion rate if the schedule falls behind.若輸注進度落後，增加輸注速率
- DMonitor the client's weight on a daily basis.✓ 正解每日監測病人的體重
- EHang 10% dextrose in water if the TPN bag runs out early.✓ 正解若全靜脈營養袋提前用完，掛上 10% 葡萄糖注射液
全靜脈營養（TPN）是一種高滲透壓且高糖分的液體，護理管理的重點在於預防感染、代謝紊亂與體液平衡。選項 A 正確，因為 TPN 含糖量高，必須密切監測血糖以防高血糖症。選項 B 正確，TPN 的高營養成分是細菌滋生的溫床，輸注管路必須每 24 小時更換一次以控管感染。選項 D 正確，每日量體重是評估 TPN 療效（蛋白質合成）與液體負荷（預防心衰竭或肺水腫）的最快方式。選項 E 正確，若 TPN 突然中斷，為避免嚴重的反應性低血糖（rebound hypoglycemia），應暫時給予 10% 葡萄糖液維持。選項 C 是錯誤的，TPN 嚴禁追趕進度，突然調快流速會造成高血糖及滲透性脫水，甚至導致滲透性利尿引發的電解質崩潰。
TPN is a hyperosmolar, high-glucose solution; nursing management focuses on preventing infection, metabolic disturbances, and fluid imbalance. A is correct because TPN's high glucose requires close blood glucose monitoring to prevent hyperglycemia. B is correct: TPN's nutrient-rich content is a breeding ground for bacteria, so tubing must be changed every 24 hours. D is correct: daily weight is the quickest way to evaluate TPN efficacy and fluid load (preventing heart failure or pulmonary edema). E is correct: if TPN is suddenly stopped, 10% dextrose should be hung to prevent rebound hypoglycemia. C is wrong: TPN must never be sped up to catch up, as it causes hyperglycemia and osmotic diuresis with electrolyte collapse.
美國 NCLEX 強調 10% 葡萄糖（D10W）作為 TPN 銜接，且嚴格執行 24 小時換管路；台灣部分醫院針對非脂質 TPN 可能會延長至 72 小時換管，但在考試中必須以美國 CDC 指引及最嚴謹的 24 小時為準。