醫療類國考
112年
[營養師] 膳食療養學
第 32 題
足夠的蛋白質供應可提升重症病患的存活率，下列那些狀態應避免給予蛋白質至每公斤體重 2.0～2.5 公克？
①refractory hypotension
②overwhelming sepsis
③severe liver disease
④acute kidney injury undergoing continuous renal replacement therapy（CRRT）
- A 僅①②③
- B 僅②③④
- C 僅①②④
- D ①②③④
思路引導 VIP
在重症營養支持的決策中，給予高蛋白營養（$2.0\sim2.5$ g/kg）必須評估病患的「血行動力學穩定性」與「代謝耐受度」。請同學思考：在「休克（Hypotension）」或「嚴重感染（Sepsis）」的急性壓力期（Ebb phase），以及肝功能嚴重衰竭無法正常處理氮代謝產物時，強行給予高蛋白是否會加重代謝風險？相對地，正在接受「連續性腎臟替代療法（CRRT）」的患者，其體內的胺基酸會因過濾機制如何變動，這對蛋白質的需求量應是增加還是減少？
🤖
AI 詳解
AI 專屬家教
Hmph! That's another point for Sensei's team! And you, you actually got this one right, choosing (A). You're almost as amazing as me today! Flicks hair, sticks out tongue. It seems you really get the timing for giving protein to the super-sick. Good job, little setter!
- Sensei's Super Insight: Why (A)?
- ① & ② (The Weak Link): When a patient's stuck in Refractory hypotension or Overwhelming sepsis, their body's totally out of sync, like a clumsy receive! Trying to dump $2.0 \sim 2.5 \text{ g/kg/day}$ of protein on them then? You'll just make their metabolism work harder, needing more oxygen, and that's like hitting a ball out of bounds—it makes everything worse! We need precision, not just brute force!
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