— 生理適應 · MEDIUM · SATA —
護理師指導一位剛確診第一型糖尿病的病患生病期間的照護方式。應包含哪些衛教內容？（選所有適合的）
A nurse is teaching a client newly diagnosed with Type 1 Diabetes Mellitus about sick day management. Which statements should the nurse include? (Select all that apply.)
- AMonitor blood glucose every 3 to 4 hours✓ 正解每 3 至 4 小時監測血糖
- BStop insulin if unable to eat若無法進食則停止注射胰島素
- CTest urine for ketones if glucose is > 240 mg/dL✓ 正解若血糖 > 240 mg/dL 則檢測尿液酮體
- DMaintain adequate fluid intake✓ 正解維持充足的水分攝取
- ECall the physician if vomiting persists✓ 正解若嘔吐持續則聯絡醫師
— Explanation · 中文詳解 —
生病期間即便進食減少，肝臟仍會釋放葡萄糖，加上壓力荷爾蒙導致血糖上升，因此絕對不能停用胰島素。監測血糖（每 3-4 小時）與尿酮（血糖 >240 mg/dL 時）至關重要，以防酮酸中毒。補充足夠水分防脫水，若持續嘔吐無法進食需尋求醫療幫助。
Clients with Type 1 Diabetes should monitor blood glucose every 3 to 4 hours and test for urine ketones if glucose exceeds 240 mg/dL to prevent diabetic ketoacidosis. They must maintain adequate fluid intake and continue taking insulin even if unable to eat. The provider should be contacted if vomiting persists.
✦ 台美臨床差異
美國透過遠距照護或糖尿病衛教師 (CDE) 進行生病日指導；台灣多由門診衛教提供紙本指引，較少即時遠距指導。