— 生理適應 · MEDIUM · MCQ —
一位第一型糖尿病病人血糖 450 mg/dL，呼氣有水果味。護理師應優先採取哪項措施？
A client with type 1 diabetes mellitus presents with a blood glucose level of 450 mg/dL and a fruity odor to the breath. Which intervention should the nurse perform first?
- AInitiate an intravenous infusion of 0.9% normal saline✓ 正解開始輸注 0.9% 生理食鹽水
- BAdminister an insulin bolus according to the sliding scale依照滑動劑量表給藥胰島素推注
- CObtain a urine sample for ketones取得尿液樣本進行酮體檢測
- DAssess the client's potassium level評估病人的鉀離子濃度
— Explanation · 中文詳解 —
糖尿病酮酸中毒（DKA）是第一型糖尿病的嚴重併發症，其病理特徵為高血糖、代謝性酸中毒與脫水。治療的首要目標是恢復循環血量，以改善組織灌流並促進腎臟排除多餘的血糖與酮體。因此，在給予胰島素之前，必須先建立靜脈通道並給予大量的等張食鹽水（0.9% Normal Saline），這是 DKA 急救處理流程的第一優先事項。
In diabetic ketoacidosis, restoring intravascular volume with 0.9% normal saline is the first priority to reverse shock and improve tissue perfusion. Fluid resuscitation must precede insulin administration to safely facilitate the clearance of glucose and ketones.