— 藥理與非經腸給藥 · EASY · MCQ —
一位第一型糖尿病病人意識不清，血糖檢測為 40 mg/dL。護理師首要採取的行動為何？
A client with type 1 diabetes is found unresponsive with blood glucose at 40 mg/dL. Which action should the nurse take first?
- ACheck the client's airway and breathing✓ 正解檢查病人的呼吸道與呼吸狀況
- BAdminister 50% dextrose IV push靜脈推注 50% 葡萄糖溶液
- COffer a glass of orange juice提供一杯柳橙汁
- DAdminister subcutaneous insulin皮下注射胰島素
— Explanation · 中文詳解 —
針對意識改變的病人，依據 ABC 原則，呼吸道（Airway）與呼吸（Breathing）永遠是最高優先級。病人血糖極低（40 mg/dL）會影響中樞神經功能，可能導致意識喪失與呼吸抑制。在確認呼吸道暢通並評估呼吸後，才進行後續的靜脈給藥。嚴禁給予無意識病人任何口服物質（如果汁），以免導致吸入性肺炎。
According to the ABC (Airway, Breathing, Circulation) framework, securing the airway and assessing breathing are the highest priorities for an unresponsive client. Although administering dextrose is necessary to treat severe hypoglycemia, the nurse must first ensure the client has a patent airway and is breathing adequately to prevent aspiration and respiratory failure.