一位第一型糖尿病病人意識喪失，血糖為 42 mg/dL。護理師應優先採取何項措施？
A client with type 1 diabetes is found unresponsive with a blood glucose level of 42 mg/dL. Which action should the nurse take first?
- AAdminister 50% dextrose IV push✓ 正解靜脈推注 50% 葡萄糖
- BAssess the client's airway評估病人的呼吸道
- CProvide an oral glucose tablet提供口服葡萄糖錠
- DAdminister subcutaneous insulin皮下注射胰島素
針對意識喪失（unresponsive）的嚴重低血糖病人，首要任務是恢復腦部葡萄糖供應。根據 ABC 原則（Airway, Breathing, Circulation），雖然呼吸道評估很重要，但病人的低血糖狀態已導致意識喪失，必須立即透過靜脈途徑補充葡萄糖。50% Dextrose (D50W) 是臨床處理低血糖急症的標準藥物，能迅速提升血中葡萄糖濃度。口服補充（選項 C）會導致誤吸（aspiration）風險，嚴重威脅呼吸道安全，因此在病人意識恢復前絕對禁止。
For an unresponsive client with severe hypoglycemia, the primary task is to restore glucose supply to the brain. According to the ABC principle (Airway, Breathing, Circulation), although airway assessment is important, the client's hypoglycemic state has already caused loss of consciousness, and glucose must be supplied immediately via the intravenous route. 50% Dextrose (D50W) is the standard medication for clinical management of hypoglycemic emergencies and can rapidly raise blood glucose. Oral administration (option C) carries an aspiration risk and seriously threatens airway safety, and is therefore absolutely prohibited before the client regains consciousness.
在美國臨床環境中，D50W 靜脈推注是常見處置。若無靜脈通道，亦可使用肌肉注射 Glucagon。台灣臨床處置邏輯一致，但需注意美國護理師常需確認醫囑（Standing orders）後執行，且對於意識不明病人，保護氣道與排除低血糖通常是同步進行的搶救流程。