— 生理適應 · MEDIUM · MCQ —
護理師照顧一位糖尿病酮酸中毒（DKA）的病人，下列哪項為首要介入措施？
A nurse is caring for a client with diabetic ketoacidosis (DKA). Which of the following is the priority intervention?
- AAdminister IV insulin靜脈注射胰島素
- BReplace potassium補充鉀離子
- CAdminister IV fluids✓ 正解靜脈輸注液體
- DAdminister sodium bicarbonate靜脈注射碳酸氫鈉
— Explanation · 中文詳解 —
糖尿病酮酸中毒（DKA）的病理機轉是高血糖導致嚴重的滲透性利尿（Osmotic diuresis），造成病人極度脫水與電解質流失。處理 DKA 的首要原則是復甦循環血量（Fluid resuscitation）。給予大量的生理食鹽水（Normal saline）能補充細胞外液，改善組織灌流，並有助於降低血糖與排除酮體。在補液後，醫師才會開立胰島素注射以糾正代謝異常。
Fluid resuscitation is the priority intervention in diabetic ketoacidosis (DKA) to restore intravascular volume, improve tissue perfusion, and help lower blood glucose through dilution and renal excretion. Insulin administration follows fluid replacement to correct metabolic abnormalities.