# 護理師發現TPN袋在下一袋預計送達前1小時已空。最適當的行動是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391891&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

護理師發現TPN袋在下一袋預計送達前1小時已空。最適當的行動是什麼？

## 選項

1. 立即改為腸道餵食
2. IV push高濃度dextrose
3. 以相同速率掛上D10W（若無D10則D5W）以預防反彈性低血糖，監測血糖，並通知藥局準備下一袋 **✔ 正確答案**
4. 拔除IV並等待

**正確答案: 3**

## 解析

正確（2）：TPN含高葡萄糖負荷；突然停止會因內源性insulin仍在循環而造成反彈性低血糖。新TPN到達前，以相同速率掛D10W（優先）或D5W，並監測血糖。若計畫性停用TPN，應於1-2小時內逐步減量。（1,3,4）錯誤。

## 深入解析

記憶提示 TPN突然停止 =「反彈性低血糖」。用D10銜接。計畫性停用需漸減。同一管路不要與TPN piggyback其他藥物。

## 臨床情境

情境 成人正接受連續中心靜脈TPN；輸液袋提早1小時用完。下一袋TPN尚未由藥局送達。

## 重要概念

- **TPN突然中止** — 有反彈性低血糖風險；以D10W銜接並監測血糖。
- **TPN漸減停用** — 計畫性停用時於1-2小時內逐步降低。
- **TPN專用管路** — TPN需要專用管路；不要piggyback藥物或抽血。

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