— 生理適應 · MEDIUM · MCQ —
病人正在使用全靜脈營養 (TPN)。若下一袋 TPN 尚未送到，護理師應掛上哪種液體以防止低血糖？
A client is receiving total parenteral nutrition (TPN). The next bag of TPN is not available on the unit. What should the nurse hang to prevent hypoglycemia?
- A10% Dextrose in Water (D10W)✓ 正解10% 葡萄糖注射液 (D10W)
- B5% Dextrose in Water (D5W)5% 葡萄糖注射液 (D5W)
- CLactated Ringer's solution乳酸林格氏溶液
- D0.9% Normal Saline0.9% 生理食鹽水
— Explanation · 中文詳解 —
TPN 含有極高濃度的葡萄糖。如果突然停止，體內高水平的胰島素會導致反彈性低血糖。為了平穩過渡，應掛上 10% 葡萄糖水（D10W）。D5W（B）濃度不足以對抗 TPN 引起的胰島素反應；NS（D）與 LR（C）不含糖。
TPN contains high concentrations of glucose, and abrupt discontinuation can cause rebound hypoglycemia due to elevated insulin levels. Hanging 10% dextrose in water (D10W) provides sufficient glucose to prevent this complication while waiting for the next TPN bag. Lower concentration dextrose or solutions without glucose are ineffective for this purpose.
✦ 台美臨床差異
美國 NCLEX 明確指出 D10W 是 TPN 中斷時的首選代用液；台灣臨床實務有時會使用 D5W，但考試應選 D10W。