一位急性胰臟炎病人正接受靜脈輸液並禁食，下列哪項評估結果是護理師需優先回報醫師的？
A client with acute pancreatitis is receiving IV fluids and is NPO. Which assessment finding is the priority for the nurse to report to the provider?
- ABowel sounds hypoactive in all four quadrants四個象限腸鳴音減弱
- BSerum amylase level of 400 U/L血清澱粉酶濃度 400 U/L
- CReports of 6/10 abdominal pain主訴腹部疼痛 6/10
- DTrousseau sign noted during blood pressure measurement✓ 正解測量血壓時出現 Trousseau 徵象
Trousseau 徵象陽性暗示低血鈣，這是急性胰臟炎常見的致命併發症。胰臟釋放的脂肪酶分解脂肪會與鈣結合形成皂化反應，導致低血鈣。血鈣過低易引起心律不整與抽搐，需立即處理。其他選項皆為胰臟炎常見的臨床表現，並非最危險的電解質異常。
A positive Trousseau sign suggests hypocalcemia, a common and potentially lethal complication of acute pancreatitis. Lipase released from the pancreas breaks down fat, which binds calcium through saponification and results in hypocalcemia. Low serum calcium can precipitate cardiac arrhythmias and tetany and must be addressed immediately. The other options are expected findings of pancreatitis and are not the most dangerous electrolyte disturbance.
美台臨床對於急性胰臟炎的監測大同小異，但台灣護理師對於 Trousseau 徵象的臨床執行頻率較低，多依賴抽血數值。