— 生理適應 · MEDIUM · MCQ —
一位急性胰臟炎病人正接受全靜脈營養（TPN）治療。下列何種臨床發現顯示可能出現 TPN 相關併發症？
A client with acute pancreatitis is receiving total parenteral nutrition (TPN). Which clinical finding indicates a potential complication of TPN administration?
- APresence of clear lung sounds肺部聽診音清晰
- BBlood glucose level of 210 mg/dL✓ 正解血糖值 210 mg/dL
- CClient report of increased thirst病人主訴口渴增加
- DSerum potassium level of 4.2 mEq/L血清鉀離子濃度 4.2 mEq/L
— Explanation · 中文詳解 —
TPN 含有高濃度的葡萄糖，可能引發代謝異常，特別是高血糖。血糖數值超過 200 mg/dL 提示需要監測胰島素需求或調整配方。B 數值正常；C 的口渴雖與高血糖有關，但 A 是更客觀的生理數據指標；D 正常代表沒有液體過量問題。
Total parenteral nutrition contains high concentrations of glucose, which significantly increases the risk of hyperglycemia in clients. A blood glucose level of 210 mg/dL indicates this potential metabolic complication, necessitating monitoring and possible insulin intervention.
✦ 台美臨床差異
美國護理師常需負責監控 TPN 輸液速率並調整胰島素滴注；台灣多依據醫囑執行，護理師負責監測血糖並回報醫師。