— 藥理與非經腸給藥 · HARD · MCQ —
病人正經由中心靜脈導管接受全靜脈營養（TPN），護理師為預防併發症，優先採取哪項措施？
A client is receiving total parenteral nutrition (TPN) through a central venous catheter. Which action is the priority for the nurse to prevent complications?
- AKeep the TPN infusion rate constant at all times始終保持TPN輸注速率恆定
- BChange the TPN tubing and filter every 24 hours✓ 正解每24小時更換TPN管路和過濾器
- CMonitor blood glucose levels every 4-6 hours每4-6小時監測血糖
- DPerform an X-ray to confirm catheter placement進行X光檢查以確認導管位置
— Explanation · 中文詳解 —
TPN 含有高濃度的葡萄糖、氨基酸與脂質，是細菌生長的絕佳培養基。為了降低導管相關血液感染（CRBSI）風險，更換輸液管路與濾器是極其關鍵的感染控制措施。B（血糖監測）雖重要，但屬於代謝性併發症預防；C 為穩定代謝，非首要感染控制；D 僅在置入時執行。
Total parenteral nutrition provides an ideal medium for bacterial growth, making infection control critical. Changing the tubing and filter every 24 hours is the priority intervention to prevent catheter-related bloodstream infections, which pose a greater immediate threat than metabolic fluctuations.
✦ 台美臨床差異
台灣醫院對 TPN 管路更換時間點常與美國一致，但在某些醫院為減少暴露，會結合靜脈營養袋更換同步處理。