— 生理適應 · EASY · MCQ —
一位慢性腎臟病 (CKD) 病人血鉀 6.2 mEq/L。護理師應預期給予哪種藥物？
A client with chronic kidney disease (CKD) has a potassium level of 6.2 mEq/L. Which medication should the nurse anticipate administering?
- APotassium chloride氯化鉀
- BSodium polystyrene sulfonate✓ 正解聚苯乙烯磺酸鈉
- CSpironolactone螺內酯
- DFurosemide呋塞米
— Explanation · 中文詳解 —
高血鉀的急救處理中，Kayexalate（Sodium polystyrene sulfonate）是一種離子交換樹脂，透過腸道排除鉀離子。Spironolactone 是保鉀利尿劑會加重高血鉀，氯化鉀更是禁忌。
In the emergency management of hyperkalemia, Kayexalate (sodium polystyrene sulfonate) is an ion-exchange resin that eliminates potassium via the intestine. Spironolactone is a potassium-sparing diuretic that worsens hyperkalemia, and potassium chloride is absolutely contraindicated.
✦ 台美臨床差異
台灣臨床使用 Kayexalate 較頻繁，美國近年較多使用新型結合劑如 Patiromer 或 ZS-9。