對於接受全靜脈營養的病人，哪項評估最為優先？

核心概念：全靜脈營養（Total Parenteral Nutrition, TPN）的護理監測優先序。 為何正確答案對： A. TPN 含有高濃度葡萄糖，容易導致血糖急劇升高（Hyperglycemia）。血糖的劇烈波動可能引發滲透壓失衡、電解質紊亂，甚至高滲透壓非酮性高血糖狀態（HHS）。因此，監測血糖是 TPN 治療中最為優先且關鍵的護理監測項目，應定時（通常每 4-6 小時）檢查。 為何其他選項錯： B. 每日體重（Daily weight）是評估 TPN 效果和水份平衡的重要指標，但相較於血糖的即時危險性，血糖監測的優先級更高。 C. 血清電解質（Serum electrolyte levels）也是 TPN 監測項目，但血糖的劇烈變動可能在短時間內發生，且直接影響生命安全，故優先級略高。 D. 體溫（Temperature）是監測感染的指標，對於 TPN 病人很重要，因為 TPN 輸液路徑易引發感染，但若單純比較，血糖的即時影響性與危險性更高。

Core concept: Priority of nursing monitoring during total parenteral nutrition (TPN). Why the correct answer is right: A. TPN contains a high concentration of glucose, which can lead to rapid spikes in blood sugar (hyperglycemia). Marked fluctuations in blood glucose may cause osmotic imbalance, electrolyte disturbances, and even hyperosmolar hyperglycemic state (HHS). Therefore, monitoring blood glucose is the most critical and highest priority nursing monitoring parameter during TPN therapy, typically checked at regular intervals (usually every 4-6 hours). Why the other options are wrong: B. Daily weight is an important indicator for evaluating the effectiveness of TPN and fluid balance, but compared with the immediate danger of blood glucose changes, glucose monitoring has higher priority. C. Serum electrolyte levels are also monitored during TPN, but blood glucose can fluctuate dramatically within a short period and directly affect life safety, so its priority is slightly higher. D. Temperature is an indicator of infection and is important for the TPN client because the TPN infusion route is prone to infection, but when comparing parameters directly, blood glucose has greater immediate impact and danger.