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護理師正在審查一位正在接受甘精胰島素的年長成人。哪項措施是優先事項？

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An 82-year-old with type 2 diabetes and chronic kidney disease receives insulin glargine 24 units every morning.一位 82 歲患有第 2 型糖尿病和慢性腎臟病的病人，每天早上接受 24 單位甘精胰島素。

BP 118/66 mm Hg, HR 92/min, RR 16/min, temperature 37.2 C.血壓 118/66 mm Hg，心率 92/min，呼吸頻率 16/min，體溫 37.2 C。

Glucose 54 mg/dL now; creatinine increased from 1.3 to 2.2 mg/dL over 48 hours; eGFR decreased from 42 to 22 mL/min/1.73 m2.目前血糖 54 mg/dL；肌酸酐在 48 小時內從 1.3 增加到 2.2 mg/dL；eGFR 從 42 降至 22 mL/min/1.73 m2。

Insulin glargine 24 units is scheduled now. Hypoglycemia protocol is active.甘精胰島素 24 單位預定現在給藥。低血糖處置方案正在執行中。

The client is diaphoretic and reports shakiness. Breakfast is delayed for a procedure.病人出汗並報告顫抖。早餐因手術而延遲。

1 Give the unchanged basal dose because long-acting insulin cannot cause prolonged hypoglycemia. 給予未改變的基礎劑量，因為長效胰島素不會引起長時間低血糖。 ✕ 2 Hold the scheduled dose, treat the current hypoglycemia, and obtain prompt dose review for the renal decline. 暫停預定劑量，治療目前的低血糖，並針對腎功能下降迅速取得劑量審查。 ✕ 3 Double the dose because acute illness usually raises glucose. 劑量加倍，因為急性疾病通常會升高血糖。 ✕ 4 Skip glucose monitoring after the client eats breakfast. 在病人吃完早餐後跳過血糖監測。 ✕

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