— 生理適應 · EASY · MCQ —
病人因糖尿病酮酸中毒（DKA）入院，護理師應首要執行下列哪項措施？
A client is admitted with diabetic ketoacidosis (DKA). Which nursing intervention should be implemented first?
- ACorrect the client's potassium levels糾正病人的鉀離子濃度
- BInitiate an intravenous infusion of 0.9% normal saline✓ 正解開始輸注 0.9% 生理食鹽水
- CObtain a bedside glucose measurement進行床邊血糖測量
- DAdminister an insulin drip as ordered依醫囑給予胰島素靜脈滴注
— Explanation · 中文詳解 —
糖尿病酮酸中毒（DKA）的病理生理關鍵在於高血糖引起的渗透性利尿，導致病人處於嚴重的脫水與電解質流失狀態。雖然高血糖需要用胰島素（D）控制，但若未先給予生理食鹽水（B）擴充循環血容量，直接使用胰島素會導致血管內水分快速移入細胞，造成循環衰竭。因此，首要措施是液體復甦，以改善腎灌流並促進血糖經由尿液排出。
Fluid replacement is the priority intervention in diabetic ketoacidosis to correct hypovolemia caused by osmotic diuresis. Initiating an intravenous infusion of 0.9% normal saline restores circulating volume before administering insulin, which could otherwise precipitate circulatory collapse by shifting fluid into cells.