# 一名65歲個案於0700接受NPH(中效)胰島素20單位皮下。護理師規劃巡房和餐時。應在哪個大概時間最警覺低血糖? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=375038&lang=zh-tw > language: zh-TW > subject: Medical Emergencies > category: PA ## 題目 一名65歲個案於0700接受NPH(中效)胰島素20單位皮下。護理師規劃巡房和餐時。應在哪個大概時間最警覺低血糖? ## 選項 1. 隔天 0700（給藥後 24 小時）— NPH insulin 常被視為長效型胰島素，因此其作用高峰及發生低血糖的最高風險出現在注射後 24 小時；請在此時密切監測血糖。 2. 1100~1900 — NPH典型peak於SC注射後約4~12小時·監測BG·確保按時餐/點心·此時段警戒低血糖徵兆。 **✔ 正確答案** 3. 在 0700，注射後立即 — 因為 NPH insulin 有時會與速效型胰島素混淆，而誤以為其起始作用在數分鐘內，因此需立即檢測血糖並提供餐點以預防低血糖。 4. 在 0730 至 0800 之間 — NPH insulin 的起始作用通常在注射後 30 至 60 分鐘，因此應在此期間監測血糖並提供餐點以預防低血糖。 **正確答案: 2** ## 解析 胰島素藥動學 — onset/peak/duration Rapid:onset 5~15分·peak 30~90分·duration 3~5h。Short(regular):onset 30分·peak 2~3h·5~8h。Intermediate(NPH):onset 1~2h·peak 4~12h·duration 14~24h·混濁。Long(glargine·detemir·degludec):無peak或微弱·12~42h。0700 NPH → peak 1100~1900須監測BG·餐/點心·警戒低血糖。 ## 深入解析 為何選2 胰島素類別kinetic: • Rapid(lispro·aspart·glulisine):onset 5~15分·peak 30~90分·duration 3~5h。餐前。 • Short(regular):onset 30分·peak 2~3h·duration 5~8h。餐前30分。 • Intermediate(NPH):onset 1~2h·peak 4~12h·duration 14~24h。混濁 — 滾動混合·勿搖。Peak為最大低血糖風險時段。 • Long(glargine·detemir·degludec):Glargine無peak·~24h·detemir微弱peak·degludec極平·≥42h。 0700 NPH → peak 1100~1900。此時段監測BG·上午點心·午餐·下午點心·低血糖警戒。 誤答 1:30~60分為onset非peak。3:NPH非長效·有peak。4:即時起效錯誤·onset 1~2h。 ## 重要概念 - **NPH insulin** — Neutral Protamine Hagedorn·中效·混濁(cloudy)。Onset 1~2h·peak 4~12h·duration 14~24h。每日1~2次。僅SC(IV禁忌)。Vial滾動混合·勿搖。可mix(與regular)。低血糖監測為要點。 - **胰島素分類** — Rapid:lispro·aspart·glulisine。Short:regular(humulin R·novolin R)。Intermediate:NPH。Long:glargine(Lantus·Toujeo)·detemir(Levemir)·degludec(Tresiba)。U-500 regular:重度胰島素抗性·high-alert。 - **Mixing胰島素** — Regular+NPH可混合(NPH含protamine)。步驟:空氣NPH→空氣R→吸R→吸NPH(R先·NPH後·同syringe)。Glargine·detemir·degludec禁混合。Premixed如70/30·75/25。 ## 相同主題題目 - [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=zh-tw) - [A 68-year-old client with COPD is admitted with shortness of breath and SpO2 86% on room a…](https://mymerci.kr/pages/nclex_q.php?qn_id=362940&lang=zh-tw) - [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=zh-tw) - [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=zh-tw) - [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=zh-tw) - [A 76-year-old female with chronic heart failure and atrial fibrillation receives digoxin 0…](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=zh-tw) - [A 70-year-old client on long-term digoxin therapy reports new yellow-green halos around li…](https://mymerci.kr/pages/nclex_q.php?qn_id=374884&lang=zh-tw) - [A 58-year-old client with type 2 diabetes mellitus and migraine prophylaxis is taking prop…](https://mymerci.kr/pages/nclex_q.php?qn_id=374893&lang=zh-tw) ## 以其他語言閱讀 - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=375038&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=375038&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=375038&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=375038&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=375038&lang=vi) --- More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw) _僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_