護理師照護一位接受全靜脈營養(PN)的病人。應執行哪項措施?
A nurse is caring for a client receiving parenteral nutrition (PN). Which action should the nurse perform?
- AIncrease the flow rate if the solution runs behind若溶液輸注落後則增加流速
- BUse a filter for all PN administration✓ 正解所有全靜脈營養輸注均使用過濾器
- CChange the IV tubing every 72 hours每 72 小時更換靜脈輸液管路
- DDraw blood from the PN line從全靜脈營養管路抽取血液
全靜脈營養(Parenteral Nutrition, PN)溶液含有高濃度的葡萄糖、胺基酸、脂肪乳劑與電解質,是細菌生長的理想培養基。使用過濾器(Filter)是為了過濾可能存在的沉澱物或微生物,保障病人安全。臨床上,絕對禁止從 PN 管路抽血或給藥,以防汙染(Infection)與藥物交互作用。此外,若輸液進度落後,嚴禁自行加快流速,因為這會導致急遽的高血糖(Hyperglycemia)與滲透壓變化,引發嚴重併發症。
Using a filter during parenteral nutrition administration is critical to prevent the infusion of precipitates or microorganisms, given that PN solutions are ideal culture media for bacterial growth. Nurses must never draw blood from or administer other medications through the PN line to avoid contamination and drug interactions, and tubing should typically be changed every 24 hours.
在美國,PN 的調配與管路管理極度嚴格,通常由靜脈治療護理師(IV Team)或藥師參與。台灣臨床上,PN 的管路管理有時會因人力配置而由一般病房護理師執行,但觀念上均需嚴格遵守感染控制原則。