# 根據其支持的安全決策，對每個靜脈營養給藥行動進行分類。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522664&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

根據其支持的安全決策，對每個靜脈營養給藥行動進行分類。

|  | 適當的給藥實踐 | 停止並取得藥學部門審查 | 不安全的實踐 |
| --- | --- | --- | --- |
| 對靜脈營養和脂肪乳劑使用醫囑要求的 1.2 微米管內過濾器 |  |  |  |
| 在可行時保留一個專用的中央靜脈導管管腔 |  |  |  |
| 繞過阻塞的過濾器以確保輸注按時完成 |  |  |  |
| 在床邊將未經核實的藥物加入靜脈營養袋中 |  |  |  |
| 當過濾器反覆阻塞時，停止輸注並聯繫藥學部門 |  |  |  |
| 在任何不可避免的共用管腔給藥之前核實相容性 |  |  |  |

## 解析

靜脈營養在可能的情況下需要專用管路或管腔、適當的管內過濾器、受保護的混合液完整性，以及藥學部門對相容性或過濾器阻塞的審查。阻塞的過濾器不能繞過。

## 深入解析

快速回答
保護混合液、管腔、過濾器和相容性鏈。

為什麼這是正確的
顆粒、沉澱物、不相容的藥物、微生物污染以及臨時繞過都可能透過中央通路直接進入循環。

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 Parenteral Nutrition Safety Consensus RecommendationsDedicated access, compatibility, admixture protection, infection prevention, laboratory surveillance, and safe administration
2ASPEN Position Paper: Update on Use of Filters for Parenteral NutritionUse of a 1.2-micron in-line filter for PN and lipid emulsion and prohibition on bypassing an occluded filter

## 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。

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