— 生理適應 · EASY · MCQ —
一位第一型糖尿病病人被發現意識不清，血糖值為 42 mg/dL。護理師應立即採取何種行動？
A client with type 1 diabetes is found unresponsive with a blood glucose level of 42 mg/dL. Which action should the nurse perform immediately?
- AAdminister 1 mg of glucagon intramuscularly✓ 正解肌肉注射 1 mg 升糖素
- BAdminister 15g of oral glucose gel給予 15g 口服葡萄糖凝膠
- CRecheck the blood glucose level using a different monitor使用不同的儀器重新測量血糖
- DStart an intravenous infusion of 0.9% normal saline開始輸注 0.9% 生理食鹽水
— Explanation · 中文詳解 —
對於意識不清的低血糖病人，口服葡萄糖有嗆入氣管導致吸入性肺炎的風險，因此必須使用非口服路徑。升糖素（Glucagon）可刺激肝醣分解，迅速提升血糖濃度，是此情境下的急救藥物。生理食鹽水無法校正低血糖，重複檢測血糖則會延誤救治時間。
In an unresponsive client with severe hypoglycemia, administering glucagon intramuscularly is the immediate priority to rapidly raise blood glucose levels. Oral administration is contraindicated due to the high risk of aspiration, and delaying treatment for retesting or fluid resuscitation is unsafe.
✦ 台美臨床差異
美國護理師常依據 Protocol 直接給予藥物；台灣臨床多半需先聯絡醫師開立醫囑後才給予升糖素。