# 一位28歲的個案嘔吐和水樣腹瀉已持續36小時。個案意識清楚，黏膜濕潤，皮膚彈性正常。生命徵象：體溫37.2°C（99°F），心率88次/分，血壓118/74 mm Hg。個案表示口渴，但可以小口喝水而不嘔吐。護理師應採取何種__0__來__1__？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=505800&lang=zh-tw  
> language: zh-TW  
> subject: Basic Care and Comfort  
> category: BCC

## 題目

一位28歲的個案嘔吐和水樣腹瀉已持續36小時。個案意識清楚，黏膜濕潤，皮膚彈性正常。生命徵象：體溫37.2°C（99°F），心率88次/分，血壓118/74 mm Hg。個案表示口渴，但可以小口喝水而不嘔吐。護理師應採取何種__0__來__1__？

一位28歲的個案嘔吐和水樣腹瀉已持續36小時。個案意識清楚，黏膜濕潤，皮膚彈性正常。生命徵象：體溫37.2°C（99°F），心率88次/分，血壓118/74 mm Hg。個案表示口渴，但可以小口喝水而不嘔吐。護理師應採取何種::선택::措施評估藥物處置來::선택::鼓勵少量多次飲用口服補充液開始靜脈輸注0.9%氯化鈉溶液，速率100 mL/小時依處方給予ondansetron 4 mg口服立即取得基礎代謝 panel？

## 解析

個案血液動力學穩定，黏膜濕潤且皮膚彈性正常，顯示輕度脫水，可經口補充水分處理。因為個案能安全飲水而不嘔吐，鼓勵少量多次飲用口服補充液是適當的。開始靜脈輸液對於輕度脫水是不必要且過度侵入的。沒有處方給予止吐藥並不適用，也無法解決體液流失。在嘗試口服補充液前，對穩定的個案立即取得基礎代謝 panel 是過早的。

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