— 生理適應 · MEDIUM · MCQ —
病人正在接受全靜脈營養（TPN）。優先的護理措施為何？
A client is receiving total parenteral nutrition (TPN). Which is the priority nursing intervention?
- AFlush the line with normal saline daily每日以生理食鹽水沖洗管路
- BKeep the client on bed rest讓病人卧床休息
- CChange the IV tubing every 48 hours每48小時更換靜脈輸液管路
- DCheck blood glucose levels regularly✓ 正解定期檢查血糖值
— Explanation · 中文詳解 —
全靜脈營養（TPN）是一種高滲透壓的營養液，含有高濃度的葡萄糖、胺基酸與電解質。其最常見的代謝併發症是「高血糖」。TPN 輸注速度過快或病人胰島素分泌不足皆會導致高血糖，進而引發滲透性利尿與高滲透壓性昏迷。因此，定期監測血糖（通常每 4-6 小時）並根據醫囑給予胰島素（sliding scale）是護理師最優先且關鍵的評估項目。
Total parenteral nutrition (TPN) contains high concentrations of glucose, making hyperglycemia a common metabolic complication due to rapid infusion rates or insufficient insulin secretion. This can lead to osmotic diuresis and hyperosmolar coma if not managed properly. Therefore, the priority nursing intervention is to regularly monitor blood glucose levels, typically every 4 to 6 hours, and administer insulin as prescribed to maintain stability.