— 生理適應 · HARD · MCQ —
護理師照顧一位第一型糖尿病病人，病人出現意識混亂、呼吸帶有水果味，且呼吸深而快。護理師應懷疑什麼狀況？
A nurse is caring for a client with type 1 diabetes mellitus. The client is confused, has fruity-smelling breath, and deep, rapid respirations. What should the nurse suspect?
- AHyperosmolar hyperglycemic state (HHS)高滲透壓高血糖狀態 (HHS)
- BRespiratory alkalosis呼吸性鹼中毒
- CDiabetic ketoacidosis (DKA)✓ 正解糖尿病酮酸中毒 (DKA)
- DHypoglycemia低血糖
— Explanation · 中文詳解 —
酮酸中毒（DKA）的典型特徵包含：血糖極高、呼氣有酮體味（水果味）、以及庫斯莫爾呼吸（Kussmaul breathing，深快呼吸），這是身體企圖透過呼出 CO2 來代償代謝性酸中毒。A 為低血糖，A 則無明顯酸中毒跡象。
The presence of confusion, fruity breath odor, and Kussmaul respirations strongly suggests diabetic ketoacidosis (DKA). These symptoms result from severe hyperglycemia, ketone production, and the body's attempt to compensate for metabolic acidosis by exhaling carbon dioxide. Unlike hypoglycemia or hyperosmolar hyperglycemic state, DKA is characterized by significant ketosis and acid-base imbalance.
✦ 台美臨床差異
兩地醫療系統皆對 DKA 採取嚴格的胰島素輸注與液體復甦 protocol。