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一位老年人正準備在胰島素治療方案變更後出院。出院摘要列出 glargine 每晚 12 單位，藥局標籤列出每晚 20 單位，而個案表示入院前使用 18 單位。完成連續性照護陳述。

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The nurse should identify ::선택::an expected difference that can wait until the next clinic visita medication discrepancy that requires reconciliationproof that the pharmacy label is always the correct sourceevidence that the client should resume the preadmission dose, then ::선택::select the lowest dose to reduce riskteach all three doses and let the client choosediscard the discharge summary and follow the pharmacy labelcontact the responsible prescriber and pharmacist to resolve the intended regimen before discharge, and finally ::선택::provide one reconciled list, use teach-back, and confirm follow-up and problem-reporting instructionsask the family to compare the documents after the client returns homedocument the discrepancy without changing the discharge processtell the client to skip glargine until the next routine appointment.

護理師應辨識 ::선택::一個可等到下次門診再處理的預期差異一個需要用藥整合的用藥差異藥局標籤永遠是正確來源的證據個案應恢復入院前劑量的證據，然後 ::선택::選擇最低劑量以降低風險教導三種劑量並讓個案自行選擇丟棄出院摘要並遵循藥局標籤在出院前聯繫負責的處方醫師及藥師，以解決預定的治療方案，最後 ::선택::提供一份整合後的清單，使用回覆示教，並確認後續追蹤與問題回報指示請家屬在個案返家後比較這些文件記錄差異但不改變出院流程告訴個案在下一次常規回診前暫停使用 glargine。

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