護理師執行全靜脈營養(TPN)輸注時,應採取哪些措施?(選所有適合的)
Which of the following actions should the nurse take when administering total parenteral nutrition (TPN) to a client? (Select all that apply.)
- AVerify the TPN bag against the physician's order✓ 正解根據醫師醫囑核對全靜脈營養(TPN)袋
- BUse an infusion pump to ensure accurate rate✓ 正解使用輸注幫浦以確保準確的輸注速率
- CChange the IV tubing every 72 hours每 72 小時更換靜脈輸液管路
- DMonitor the client's blood glucose levels✓ 正解監測病人的血糖水平
- EUse a micron filter during administration✓ 正解輸注期間使用微濾過器
全靜脈營養(TPN)是一種高滲透壓、高營養的混合液,提供病人所需的所有營養。由於其成分組成複雜且糖分濃度高,極易成為細菌溫床,同時容易引起高血糖與電解質不平衡。護理師在執行時必須嚴格遵守「三讀五對」進行核對,使用幫浦(infusion pump)確保滴速穩定,並在給藥系統中使用微濾過器(micron filter)過濾掉可能的沉澱物。血糖監測是必須的,因高糖負荷會導致醫源性高血糖。
Total parenteral nutrition (TPN) is a high-osmolarity solution that serves as a culture medium for bacteria and can cause hyperglycemia. Nurses must verify orders, use an infusion pump for accurate delivery, monitor blood glucose, and use a micron filter to remove particulates, while changing tubing every 24 hours rather than 72.
在美國臨床,TPN 輸注管路更換頻率通常嚴格要求每 24 小時,部分醫院甚至配合營養袋更換同步處理。台灣臨床亦遵循此原則,但在管路更換的細節上,美國更強調無菌操作技術(aseptic technique)。