護理師準備為病人更換新的全靜脈營養(TPN)。護理師發現藥劑科尚未送達 TPN。在此期間護理師應掛上什麼?
A nurse is preparing to hang a new bag of Total Parenteral Nutrition (TPN) for a client. The nurse notices the TPN bag is not available from the pharmacy yet. What should the nurse hang in the meantime?
- ALactated Ringer's乳酸林格氏液
- B10% Dextrose in Water (D10W)✓ 正解10% 葡萄糖水 (D10W)
- C0.9% Normal Saline0.9% 生理食鹽水
- D5% Dextrose in 0.45% Normal Saline5% 葡萄糖及 0.45% 生理食鹽水
全靜脈營養(TPN)含有高濃度的葡萄糖,是病人主要的熱量來源。若 TPN 突然中斷或延遲,病人體內的葡萄糖供應會驟然減少,胰臟可能仍持續分泌胰島素以應對之前高血糖負荷,進而導致嚴重的「反彈性低血糖」(rebound hypoglycemia)。低血糖是一種危及生命的緊急情況,可能導致腦損傷、癲癇甚至死亡。因此,在等待新的 TPN 送達期間,護理師必須提供含有足夠葡萄糖濃度的靜脈輸液,以維持病人的血糖穩定,確保病人安全。 正確選項 D10W(10% 葡萄糖水)能提供足夠的葡萄糖,有效預防 TPN 中斷引起的低血糖,是此情況下最安全的替代方案。
When TPN is delayed, 10% Dextrose in Water (D10W) should be hung to prevent rebound hypoglycemia caused by sudden withdrawal of high glucose loads. TPN contains high concentrations of dextrose, and abrupt interruption can lead to dangerous drops in blood sugar; D10W provides sufficient glucose to maintain stability until the TPN is available.