14.有關靜脈營養之敘述，下列何者最不適當？
(A)多數病人剛開始接受靜脈營養的24小時，建議dextrose量限制在250 g
(B)在糖尿病或是高血糖病人，剛開始24小時建議dextrose量限制在150 g
(C)建議dextrose infusion rate 4～5 mg/kg/min（20～25 kcal/kg/day）
(D)建議使用靜脈營養1週後，再調整輸注速率至目標值

靜脈營養的輸注速率：

glucose：0.25 g/kg/hr = 4 mg/kg/min 

A.A.：0.1 g/kg/hr = 1.67 mg/kg/min 

fat：0.15 g/kg/hr = 2.5 mg/kg/min

注意單位後換算即可

(A)(B)Standard practice for administering parenteral nutrient formulations containing hypertonic dextrose is to begin at a slow infusion rate of less than 250 g during the first 24 hours for most patients and less than 150 g for patients with known diabetes.

ref. Applied Therapeutics 10th p.916

(C)Hyperglycemia can be minimized by limiting the dextrose infusion rate to less than 4 mg/kg/minute.

ref. Applied Therapeutics 10th p.917

(D)The infusion is increased slowly during the next 24 to 48 hours to the goal infusion rate. This initial period allows the clinician to assess the patient's ability to tolerate the nutrient formulation components and to avoid metabolic complications, primarily hyperglycemia.

ref. Applied Therapeutics 10th p.916

用常理來想

如果有狀況1周後才測，可能就歸西去了

其他三個選項又看起來要求很謹慎

選一個最不同的答案 D