# 完成嚴重營養不良病人開始腸道外營養的計畫。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=513952&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

完成嚴重營養不良病人開始腸道外營養的計畫。

因為最終輸注液為 1050 mOsm/L，請使用 ::선택::短周邊導管中央靜脈導管皮下輸注部位用於長期治療的骨髓內管路。開始營養 ::선택::以全速且不滴定僅在禁食 7 天後根據處方計畫逐步進行作為靜脈推注，同時監測 ::선택::血糖、磷、鉀和鎂僅視力和聽力僅澱粉酶僅皮膚測試。

## 解析

輸注液滲透壓達到或超過 900 mOsm/L 需要中央通路。營養應逐步推進，同時監測血糖和電解質以防再餵食併發症。

## 深入解析

快速解答
使用中央導管，逐步推進，並監測血糖以及磷、鉀和鎂。

為何這是正確的
CLINIMIX E 標示根據最終滲透壓決定中央或周邊給藥，並警告再餵食併發症、高血糖和電解質失衡。高風險病人需要逐步開始和實驗室監測。

簡單類比或心像
濃縮溶液需要更寬廣的「高速公路」，而耗竭的代謝需要逐步重啟並進行「儀表板」監測。

記憶點
高滲透壓走中央；高再餵食風險則緩慢進行並監測實驗室數據。

NCLEX 決策規則
將血管通路與最終滲透壓匹配，並將推進速度與代謝風險匹配。

為何其他選項是錯誤的
周邊管路不適用於此滲透壓，且快速全速營養會加劇再餵食的變化。References
1DailyMed: CLINIMIX ERoute selection by osmolarity and refeeding monitoring

## 臨床情境

腸道外營養開始
在推進之前和期間，確認最終滲透壓、血管途徑、血糖、體液狀態以及磷、鉀和鎂。

## 相同主題題目

- [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=zh-tw)
- [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=zh-tw)
- [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=zh-tw)
- [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=zh-tw)
- [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=zh-tw)
- [A nurse is monitoring a client receiving a continuous IV heparin infusion for pulmonary em…](https://mymerci.kr/pages/nclex_q.php?qn_id=363988&lang=zh-tw)
- [A nurse is preparing to initiate a weight-based continuous IV unfractionated heparin infus…](https://mymerci.kr/pages/nclex_q.php?qn_id=364107&lang=zh-tw)
- [A nurse is providing discharge teaching to a 65-year-old client newly prescribed warfarin …](https://mymerci.kr/pages/nclex_q.php?qn_id=364872&lang=zh-tw)

## 以其他語言閱讀

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=513952&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=513952&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=513952&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=513952&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=513952&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。_