— 健康促進與維護 · MEDIUM · MCQ —
護理師為一位第二型糖尿病個案規劃出院指導。下列哪項建議對於預防長期併發症最為重要？
A nurse is preparing a discharge plan for a client with type 2 diabetes. Which teaching point is essential for preventing long-term complications?
- AIncrease insulin dosage if blood glucose is high若血糖偏高則增加胰島素劑量
- BAvoid all carbohydrates to keep blood sugar low避免攝取所有碳水化合物以保持低血糖
- CCheck blood glucose only when feeling symptomatic僅在有症狀時檢查血糖
- DInspect feet daily for sores or blisters✓ 正解每日檢查足部是否有潰瘍或水泡
— Explanation · 中文詳解 —
糖尿病長期併發症常因神經病變導致感覺遲鈍，腳部微小傷口若未察覺易演變為嚴重潰瘍與感染。每日足部檢查是預防糖尿病足截肢的最有效手段。A 錯誤：不能隨意調高胰島素；B 錯誤：應攝取複合式碳水化合物，而非完全不吃；C 錯誤：應規律監測，不可僅憑感覺。
Diabetic neuropathy often causes decreased sensation in the feet, making daily inspection critical for early detection of sores or blisters to prevent severe infection or amputation. Clients should not adjust insulin without orders, must include complex carbohydrates, and should monitor blood glucose regularly rather than only when symptomatic.
✦ 台美臨床差異
美國有完備的「糖尿病衛教師」（CDE）制度；台灣則由醫院衛教團隊統籌，但個案出院後的自主管理教育仍需加強。