— 生理適應 · MEDIUM · SATA —
病人正在接受全靜脈營養(TPN)。下列哪些臨床表現提示病人出現高血糖?(選所有適合的)
A client is receiving total parenteral nutrition (TPN). Which clinical manifestations suggest the client is experiencing hyperglycemia? (Select all that apply.)
- AIncreased urinary output✓ 正解尿量增加
- BThirst and dry mucous membranes✓ 正解口渴與黏膜乾燥
- CBradycardia心動過緩
- DConfusion✓ 正解意識混亂
- EWeakness✓ 正解虛弱
— Explanation · 中文詳解 —
TPN 因含高濃度葡萄糖,易引發高血糖。症狀包括滲透性利尿造成的尿量增加(A)、脫水導致口渴與黏膜乾燥(B)、腦細胞高滲透導致意識混亂(D)以及能量代謝異常引起的虛弱(E)。心跳過緩(C)通常與高血鉀或嚴重代謝酸中毒有關,非高血糖常見表現。
Total parenteral nutrition contains high glucose concentrations, which can cause hyperglycemia. Clinical signs include increased urinary output from osmotic diuresis, thirst and dry mucous membranes due to dehydration, confusion from osmotic shifts, and weakness from cellular energy deficits.
✦ 台美臨床差異
台灣護理師執行 TPN 給藥需嚴格遵守「雙人核對」原則;美國依醫院 protocol,部分機構針對特定製劑可簡化流程。