A nurse is caring for a client with type 2 diabetes mellitus… | 마이메르시 MyMerci
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문제

A nurse is caring for a client with type 2 diabetes mellitus who has developed diabetic nephropathy. Which nursing intervention is most appropriate to prevent further progression of kidney damage?

The nurse is developing a care plan for a client with diabetic nephropathy to prevent further renal complications.
해설
Strict blood pressure control is the most critical intervention to prevent progression of diabetic nephropathy, as hypertension accelerates kidney damage in diabetic patients.

심화 해설

護理學核心解析 核心概念分析 (Key Concept)：這道題目在考驗對於 糖尿病腎病變 (Diabetic Nephropathy) 護理重點的理解。糖尿病腎病變是糖尿病最嚴重的微血管併發症之一，其病理機轉是長期高血糖導致腎絲球基底膜增厚、腎絲球高壓與過濾率增加，最終造成腎絲球硬化與蛋白尿。要延緩其惡化，核心！關鍵在於控制兩個主要危險因子：血糖 (Blood glucose) 與 血壓 (Blood pressure)，其中又以嚴格控制血壓為首要之務。

正確答案依據 (Answer Rationale)：核心！選擇④「實施嚴格的血壓控制措施」是正確的。根據實證醫學，對於糖尿病腎病變患者，高血壓 (Hypertension) 是加速腎功能惡化的獨立且強力的危險因子。嚴格控制血壓（通常目標為

임상 시나리오

護理臨床實務指南 臨床情境 (Clinical Scenario)：門診一位罹患第二型糖尿病10年的58歲陳先生，最近健康檢查發現尿液微白蛋白升高，診斷為早期糖尿病腎病變。他擔心會洗腎，詢問護理師該怎麼做才能保護腎臟。

護理處置策略 (Nursing Intervention)： 1. 評估 (Assessment)：詳細了解陳先生目前的血糖控制情況（最近一次HbA1c值、自我監測頻率）、血壓值、用藥史（是否有服用ACEI/ARB）、飲食習慣（特別是蛋白質與鹽分攝取）、以及對疾病的認知與擔憂。
2. 護理目標設定 (Goal Setting)：與病人共同設定可達成的短期目標，例如：「在一個月內，透過飲食調整將每日鹽分攝取控制在5公克以下」或「學會正確且規律地在家測量血壓」。
3. 護理措施 (Intervention)： - 核心！血壓控制衛教：教導每日定時測量並記錄血壓的重要性，強調目標值為

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