— 照護管理 · HARD · MCQ —
護理師準備為病人輸注全靜脈營養（TPN）。為確保病人安全，下列哪項行動最為優先？
A nurse is preparing to administer TPN to a client. Which action is the highest priority to ensure client safety?
- AAssess the patency of the central venous line評估中心靜脈導管的通暢性
- BEnsure the infusion pump is programmed correctly確保輸注幫浦設定正確
- CCheck the expiration date on the TPN bag檢查 TPN 袋的有效期
- DVerify the TPN order with a second nurse✓ 正解與第二位護理師核對 TPN 醫囑
— Explanation · 中文詳解 —
TPN 是高警訊藥物（High-alert medication），其配方複雜且含有高濃度葡萄糖與電解質，若處方錯誤會危及病人代謝狀態。根據安全給藥流程，執行雙人核對（Double-check）是預防嚴重給藥錯誤的最重要護理步驟，勝過單純的儀器設定或管路評估。
Total parenteral nutrition (TPN) is classified as a high-alert medication due to its complex formulation and potential for severe metabolic complications if errors occur. Independent double-verification by two nurses is the highest priority safety measure to prevent administration errors. While checking patency, expiration dates, and pump settings are important, they are secondary to validating the correct prescription.
✦ 台美臨床差異
美台均高度重視高警訊藥物核對，但在美國，TPN 的雙人核對通常需要由兩位註冊護理師（RN）執行。