— 降低風險 · MEDIUM · SATA —
病人透過中心靜脈導管接受全靜脈營養 (TPN)。哪些護理措施有助於降低風險？（選所有適合的）
A client is receiving total parenteral nutrition (TPN) via a central line. Which of the following nursing actions are appropriate to reduce risks? (Select all that apply.)
- AMonitor blood glucose every 6 hours✓ 正解每6小時監測血糖
- BChange the TPN tubing every 24 hours✓ 正解每24小時更換TPN管路
- CAbruptly stop the infusion if the client feels full若病人感到飽脹，立即停止輸注
- DUse a dedicated port for TPN infusion✓ 正解使用專用端口進行TPN輸注
- EHang 10% dextrose in water if the next TPN bag is delayed✓ 正解若下一袋TPN延遲，掛上10%葡萄糖注射液
— Explanation · 中文詳解 —
TPN 護理重點：1. 監測血糖（高糖溶液易致高血糖）；2. 每 24 小時換管路（降低感染風險）；3. 專用管路（減少污染）；4. 不可突然停藥，若藥袋銜接不及應掛 D10W 以防反彈性低血糖。C 錯誤：突然停止 TPN 會引發嚴重低血糖風險。
Appropriate TPN nursing actions include monitoring blood glucose frequently due to high dextrose content, changing tubing every 24 hours to minimize infection risk, using a dedicated port to prevent contamination, and hanging 10% dextrose if the TPN supply is delayed to prevent rebound hypoglycemia. Abruptly stopping TPN is contraindicated as it can cause severe hypoglycemia.
✦ 台美臨床差異
美國臨床護理師對 TPN 血糖管理有較大自主權（常搭配 Insulin sliding scale）；台灣多依據固定時段醫囑。