護理師教導一位新診斷的一型糖尿病病人如何監測血糖。病人的哪項描述顯示需要進一步衛教？
A nurse is teaching a client with newly diagnosed type 1 diabetes about blood glucose monitoring. Which statement by the client indicates a need for further teaching?
- AI will use the center of my fingertip to get the best blood drop.✓ 正解我會使用指尖中心來取得最佳血滴
- BI will check my blood sugar before every meal and at bedtime.我會在每餐前及睡前檢查血糖
- CI should wash my hands with soap and water before testing.測試前我應該用肥皂和水洗手
- DI will keep a log of my results to show my doctor.我會記錄結果以呈現給醫師看
血糖監測的衛教重點在於減輕病人的不適感並確保結果準確。指尖採血應選擇「手指兩側」（Sides of the fingertips），而非正中央（Center）。這是因為指尖中央的神經末梢分布最密集，採血時疼痛感最強，且長期在中央採血容易導致局部形成硬繭，影響血液流出。選擇兩側不僅痛感較輕，且血管供應同樣充足。其餘選項：飯前與睡前監測是標準建議（B）；洗手可防止污染物影響數值（C）；記錄日誌對於醫師調整劑量至關重要（D）。護理師必須確保病人學會正確的技術，以增加其長期居家監測的遵從性，從而減少糖尿病急性併發症（如 DKA）的風險。
The key teaching focus for blood glucose monitoring is to reduce client discomfort and ensure result accuracy. Fingertip lancing should target the sides of the fingertips rather than the center. The center of the fingertip has the densest distribution of nerve endings, making lancing most painful, and chronic central sampling can produce calluses that hinder blood flow. Lancing the sides not only causes less pain but offers comparable blood supply. As for the other options: checking before meals and at bedtime is standard recommendation (B); washing hands prevents contaminants from affecting readings (C); and maintaining a logbook is essential for physician dosage adjustment (D). The nurse must ensure the client masters correct technique to enhance long-term home-monitoring adherence and reduce the risk of acute diabetic complications such as DKA.
美國極力推廣連續血糖監測 (CGM) 系統，許多 NCLEX 考題已開始加入相關護理；台灣雖然也普及 CGM，但在基層或剛診斷的衛教中，仍以傳統的指尖採血技術與日誌手寫為主。