— 藥理與非經腸給藥 · HARD · MCQ —
病人正在接受全靜脈營養（TPN）。藥局尚未準備好下一袋營養液。護理師優先採取何項措施？
A client is receiving total parenteral nutrition (TPN). The next bag is not available from the pharmacy. What is the nurse's priority action?
- ASlow the TPN infusion rate減慢全靜脈營養（TPN）輸注速率
- BIncrease the IV rate of maintenance fluids增加維持性靜脈輸液的速率
- CFlush the line with normal saline以生理食鹽水沖洗管路
- DAdminister 10% dextrose in water via the same line✓ 正解經由同一管路給予 10% 葡萄糖水
— Explanation · 中文詳解 —
TPN 含有高濃度的葡萄糖，若突然停止輸注，病人極易發生反彈性低血糖。若 TPN 中斷，必須在同一管路給予含有 D10W 或 D20W 的點滴，以維持血糖穩定直到新的 TPN 到達。單純沖洗管路或暫停輸注皆會導致嚴重的代謝性併發症。
Total parenteral nutrition contains high concentrations of glucose, and abrupt discontinuation can lead to rebound hypoglycemia. To maintain metabolic stability while waiting for a new bag, the nurse should administer 10% dextrose in water through the same line. This prevents dangerous drops in blood sugar levels.
✦ 台美臨床差異
美台臨床皆視為緊急情況，需跨單位協調；美國護理師常有權限直接掛上 D10W，台灣可能需先取得醫師口頭醫囑。