— 藥理與非經腸給藥 · HARD · MCQ —
病人正在接受全靜脈營養（TPN），哪項護理措施對預防感染最為關鍵？
A client is receiving total parenteral nutrition (TPN). Which nursing intervention is essential to prevent infection?
- ACheck glucose levels every 4 to 6 hours每 4 至 6 小時檢查血糖
- BKeep the TPN solution in a warm area將 TPN 溶液置於溫暖處
- CChange the IV tubing and filter every 24 hours✓ 正解每 24 小時更換靜脈輸液管路及過濾器
- DAdminister the TPN via a peripheral IV line經周邊靜脈輸注 TPN
— Explanation · 中文詳解 —
TPN 含高糖高蛋白，極易滋生細菌。為預防導管相關血液感染（CRBSI），管路與濾器需嚴格遵守定時更換原則（通常為 24 小時）。D錯誤：TPN 需由中心靜脈導管給予；B錯誤：需冷藏但給藥前應回溫；D與感染預防無關。
TPN, with its high glucose and protein content, readily supports bacterial growth. To prevent catheter-related bloodstream infection (CRBSI), the tubing and filter must be changed on a strict schedule, generally every 24 hours. Option D is incorrect: TPN must be administered through a central venous catheter. Option B is incorrect: TPN must be refrigerated but warmed to room temperature before infusion. Option A is unrelated to infection prevention.
✦ 台美臨床差異
美國醫院針對 TPN 處置多由專責營養團隊與護理師高度合作，台灣則多由醫師與護理師共同監控，管路更換時程遵循院內感染控制指引。