— 藥理與非經腸給藥 · HARD · MCQ —
病人經由中心靜脈導管接受全靜脈營養（TPN）。目前藥袋已空，但藥劑科尚未送來新藥袋。護理師應先掛上哪種點滴？
A client is receiving total parenteral nutrition (TPN) via a central line. The TPN bag is empty, and the new bag is not available from the pharmacy. Which IV fluid should the nurse hang?
- A10% Dextrose in Water (D10W)✓ 正解10% 葡萄糖水溶液 (D10W)
- B0.9% Normal Saline0.9% 生理食鹽水
- C5% Dextrose in Water (D5W)5% 葡萄糖水溶液 (D5W)
- DLactated Ringer's solution乳酸林格氏液
— Explanation · 中文詳解 —
TPN 含有高濃度葡萄糖。若突然停止，胰島素分泌尚未調整，會導致嚴重反彈性低血糖（Rebound hypoglycemia）。掛上 10% 葡萄糖水（D10W）可以維持血糖穩定，直到新的 TPN 送達。5% 葡萄糖不足以維持 TPN 等級的血糖需求。
When a TPN bag is empty and a replacement is unavailable, the nurse should hang 10% Dextrose in Water (D10W) to prevent rebound hypoglycemia. TPN contains high concentrations of glucose, and abrupt discontinuation can cause a dangerous drop in blood sugar levels. D10W provides sufficient glucose to maintain stability until the new TPN infusion is ready.
✦ 台美臨床差異
台美臨床處理原則一致。但在美國 NCLEX 中，D10W 被視為 TPN 中斷時唯一正確的預防低血糖選項。