— 生理適應 · HARD · MCQ —
護理師照護糖尿病酮酸中毒（DKA）病人，下列哪項檢驗結果證實代謝性酸中毒已緩解？
A nurse is caring for a client with DKA. Which laboratory finding confirms the resolution of metabolic acidosis?
- ASerum glucose < 200 mg/dL血清葡萄糖 < 200 mg/dL
- BUrine ketones negative尿酮體陰性
- CSerum bicarbonate > 18 mEq/L✓ 正解血清碳酸氫鹽 > 18 mEq/L
- DSerum potassium 4.0 mEq/L血鉀 4.0 mEq/L
— Explanation · 中文詳解 —
DKA 診斷與緩解標準取決於代謝狀態與血糖。根據 ADA 指南，DKA 緩解的代謝指標包括血清重碳酸根離子（HCO3-）大於 15-18 mEq/L。雖然血糖下降是治療目標，但它不直接代表酸中毒改善。酮體消失通常較慢，且血鉀水平易受胰島素影響，非酸鹼指標。
The nurse can delegate standardized, low-risk tasks such as recording vital signs, assisting with ambulation, providing hygiene care, and documenting urine output to Unlicensed Assistive Personnel (UAP). However, patient education regarding insulin administration requires professional assessment and teaching skills that must be performed by the registered nurse.
✦ 台美臨床差異
美台對 DKA 緩解標準一致，但美國護理師在監測與胰島素滴定上的自主權較大，台灣則高度依賴醫囑。