— 藥理與非經腸給藥 · HARD · MCQ —
病人正透過中心靜脈導管接受全靜脈營養 (TPN)。護理師發現營養液袋已空，但下一袋尚未送達，應採取何項行動？
A client is receiving total parenteral nutrition (TPN) through a central venous catheter. The nurse notices the TPN bag is empty, but the next bag has not arrived. What should the nurse do?
- AAdminister D10W at the same infusion rate✓ 正解以相同輸注速率給予 10% 葡萄糖溶液
- BHang a bag of normal saline until the TPN arrives掛上一瓶生理食鹽水直到 TPN 送達
- CKeep the line clamped until the TPN is available夾住管路直到 TPN 可用
- DFlush the catheter with heparinized saline用肝素化生理食鹽水沖洗導管
— Explanation · 中文詳解 —
全靜脈營養（TPN）含有高濃度的葡萄糖，若突然中斷，病人體內的胰島素濃度仍維持在相對高點，極易導致嚴重的低血糖反應（rebound hypoglycemia）。在臨床上，若 TPN 營養袋用罄但下一袋尚未送達，護理師必須立即改掛相同流速的 D10W（10% 葡萄糖水）以銜接能量供給，防止血糖急劇下降。這是護理安全中的標準處置。
Sudden discontinuation of TPN can cause rebound hypoglycemia because insulin levels remain elevated. To prevent this dangerous drop in blood glucose, the nurse should immediately hang D10W at the same infusion rate until the next TPN bag arrives.