# 一位嚴重營養不良的病人開始接受靜脈營養後出現新的發現。哪一個計畫是最好的？ > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=522662&lang=zh-tw > language: zh-TW > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## 題目 一位嚴重營養不良的病人開始接受靜脈營養後出現新的發現。哪一個計畫是最好的？ History Vitals Labs Orders Notes 過去 10 天攝取量極少，近期體重明顯減輕；昨日開始靜脈營養 (데이터 없음) (데이터 없음) 營養進展和電解質補充需要臨床再評估 (데이터 없음) 1 立即進展到全熱量目標並延遲電解質補充。 ✕ 2 減慢或暫停熱量進展，補充不足的電解質，提供醫囑要求的硫胺素，並密切監測。 ✕ 3 因為血清磷水平下降，所以從營養配方中移除所有磷。 ✕ 4 以無限制的鈉來治療水腫，並停止檢查心律。 ✕ ## 解析 營養開始後，磷快速下降並伴隨虛弱、水腫和異位搏動，這與再餵食症候群相符。該計畫旨在減少熱量負荷、糾正電解質、支持硫胺素需求並加強監測。 ## 深入解析 快速回答 在增加熱量之前應對再餵食生理學。 為什麼這是正確的 胰島素驅動的細胞內轉移會迅速耗盡磷、鉀和鎂，並損害心臟、呼吸和神經功能。 簡單類比或心像 將每次輸注視為一個受控的臨床系統：核實產品和通路、辨識變化的線索、停止可預防的暴露、穩定病人並確認反應。 記憶點 產品、通路、相容性、輸注線索、保護性措施和再評估。 NCLEX 決策規則 選擇能預防最即時輸注相關傷害的行動，同時保留血管通路和醫囑要求的診斷證據。 為什麼其他選項是錯誤的 重新啟動可疑產品、繞過安全裝置、強行通過阻塞管路或延遲再評估的選項，可能會將可逆的警訊轉變為嚴重的傷害。References 1ASPEN Consensus Recommendations for Refeeding SyndromeRisk identification, cautious calorie initiation, electrolyte monitoring and replacement, and thiamine support 2DailyMed: CLINIMIX sulfite-free parenteral nutritionHyperglycemia, refeeding syndrome, infection, laboratory monitoring, and safe discontinuation considerations ## 臨床情境 血液製品、營養和靜脈輸液安全審查 核實產品、醫囑、途徑、通路裝置、過濾器或管路、相容性、基準發現、新出現的不良線索、應對計畫和可衡量的追蹤。 ## 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=522662&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=522662&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=522662&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=522662&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=522662&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。_