病人經由中央靜脈導管接受全靜脈營養（TPN）。護理師發現 TPN 袋已空，但藥劑部尚未送達下一袋。護理師應先掛上哪種溶液？
A client is receiving total parenteral nutrition (TPN) via a central line. The nurse notes the TPN bag is empty, and the next bag is not yet available from the pharmacy. Which solution should the nurse hang?
- A0.9% sodium chloride0.9% 氯化鈉
- B5% dextrose in 0.45% sodium chloride含 0.45% 氯化鈉之 5% 葡萄糖溶液
- CLactated Ringer's乳酸林格氏液
- D10% dextrose in water (D10W)✓ 正解10% 葡萄糖水 (D10W)
TPN 含有高濃度葡萄糖，突然中斷會導致嚴重的反彈性低血糖。為預防低血糖，在等待下一袋 TPN 時應給予 10% 葡萄糖水（D10W）。生理食鹽水或 LR 無法提供足夠糖分維持血糖；D5 濃度過低，無法模擬 TPN 的高糖環境。
Total parenteral nutrition (TPN) contains high concentrations of dextrose, and abrupt discontinuation can cause severe rebound hypoglycemia. To prevent this complication while waiting for a new TPN bag, the nurse should hang 10% dextrose in water (D10W), which provides sufficient glucose to maintain blood sugar levels. Normal saline or lactated Ringer's lack adequate dextrose, and 5% dextrose solutions are generally insufficient to mimic the high glucose load of TPN.
這是美國 NCLEX 經典考點。台灣臨床有時會下調流速（KVO）等待藥物，但根據標準指引，應使用 D10W 維持血糖平穩。