# 一位病人接受速效胰島素後只吃了幾口早餐，目前清醒、盜汗且發抖。床邊血糖值為 58 mg/dL，且病人可安全吞嚥。請為每組選出所有適用的選項。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=603012&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位病人接受速效胰島素後只吃了幾口早餐，目前清醒、盜汗且發抖。床邊血糖值為 58 mg/dL，且病人可安全吞嚥。請為每組選出所有適用的選項。

與目前血糖問題一致的表徵

盜汗與顫抖

新出現的煩躁與難以專注

數天內逐漸出現的多尿

皮膚溫暖乾燥伴隨逐漸口渴

針對此清醒病人的立即護理處置

給予 15 g 快速作用碳水化合物

於 15 分鐘後重新檢測血糖

因巧克力含有糖分，以巧克力作為首選治療

在治療低數值前先給予排程的長效胰島素

## 解析

血糖 58 mg/dL 伴隨出汗、發抖與認知改變，屬於低血糖。因病人清醒且可吞嚥，應採用 15-15 原則：給予 15 g 快速碳水化合物，並於 15 分鐘後重新檢測。

## 深入解析

快速解答
表徵：盜汗／顫抖與認知改變。處置：給予 15 g 快速碳水化合物，並於 15 分鐘後重新檢測血糖。
為何此為最佳處置
測量值低於 70 mg/dL，且病人可安全口服碳水化合物，故適用 15-15 原則。
為何其他選項不適用
多尿與逐漸口渴較符合高血糖。巧克力含有脂肪，會減緩糖分吸收；且在治療低血糖之前不可額外給予胰島素。
**參考資料**
- CDC — Treatment of Low Blood Sugar

- CDC — Low Blood Sugar Symptoms

## 重要概念

- **15-15 rule** — 給予 15 g 碳水化合物，並於 15 分鐘後重新檢測血糖。
- **Fast-acting carbohydrate** — 一種可被快速吸收的糖分來源；高脂食物的作用較慢。

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