— 生理適應 · MEDIUM · MCQ —
糖尿病酮酸中毒（DKA）病人，哪項護理行動優先？
A client has a diagnosis of Diabetic Ketoacidosis (DKA). Which nursing action is the highest priority?
- AAdminister IV regular insulin靜脈注射常規胰島素
- BMonitor blood glucose levels hourly每小時監測血糖
- CAssess for Kussmaul respirations評估庫斯莫爾氏呼吸
- DInitiate isotonic fluid replacement✓ 正解開始等張液體補充
— Explanation · 中文詳解 —
糖尿病酮酸中毒（DKA）病人因高血糖引發滲透性利尿，導致嚴重脫水與電解質流失。在處理 DKA 時，ABC 原則中 Circulation（循環）優先於 Glucose control（血糖控制）。若未先補充液體以恢復有效循環血量與腎臟灌流，單獨使用胰島素會導致血管內液體進一步移入細胞內，引發休克或低血鉀惡化。
In diabetic ketoacidosis, severe dehydration from osmotic diuresis compromises circulation, making fluid resuscitation the priority over insulin administration. Initiating isotonic fluids restores circulating volume and renal perfusion, preventing the dangerous shift of fluid into cells that could occur if insulin were given first.