— 生理適應 · EASY · MCQ —
一位 45 歲第一型糖尿病病人意識不清，血糖值為 42 mg/dL。護理師應優先採取哪項行動？
A 45-year-old client with Type 1 diabetes is found unresponsive with a blood glucose level of 42 mg/dL. Which action should the nurse take first?
- AAdminister 1 mg of glucagon intramuscularly肌肉注射 1 mg 升糖素
- BAdminister 50% dextrose solution intravenously✓ 正解靜脈注射 50% 葡萄糖溶液
- CRecheck blood glucose level重新測量血糖值
- DProvide 15 grams of simple carbohydrates orally口服提供 15 克簡單碳水化合物
— Explanation · 中文詳解 —
對於意識不清的低血糖病人，首要目標是快速提升血糖以保護腦部功能。口服糖分（選項D）會造成吸入性肺炎，絕對禁忌。靜脈注射葡萄糖為醫療急救的首選方式，能立即改善神經功能。Glucagon（選項A）通常用於無法建立靜脈路徑時，非第一線最快手段。
In an unresponsive client with severe hypoglycemia, intravenous administration of 50% dextrose is the priority to rapidly restore blood glucose levels and protect neurological function. Oral carbohydrates are contraindicated due to the aspiration risk, and glucagon is reserved for situations where IV access is unavailable. Immediate intervention is critical to reverse neuroglycopenia.
✦ 台美臨床差異
美國護理師常依據急救 protocol 直接給藥，台灣臨床多需遵照醫囑給予 D50W，除非為 ACLS 緊急狀況。