一位 55 歲慢性腎衰竭病人出現嚴重高血鉀，護理師預期給予下列哪種藥物以穩定心肌細胞膜？
A 55-year-old client with chronic renal failure is experiencing severe hyperkalemia. Which medication should the nurse expect to administer to stabilize the cardiac membrane?
- ARegular insulin and Dextrose 50%普通胰島素與50%葡萄糖
- BCalcium gluconate✓ 正解葡萄糖酸鈣
- CSodium polystyrene sulfonate聚苯乙烯磺酸鈉
- DSodium bicarbonate碳酸氫鈉
高血鉀會導致心律不整，鈣離子（葡萄糖酸鈣）雖不直接降低血鉀濃度，但能有效拮抗鉀離子對心肌電生理的影響，穩定心肌細胞膜，防止致命性心律不整。胰島素與葡萄糖是加速鉀離子進入細胞內，降鉀樹脂則是排除鉀離子，非穩定膜之首選。
Hyperkalemia can cause arrhythmias. Calcium (calcium gluconate), although it does not directly lower serum potassium, effectively antagonizes the effects of potassium on cardiac electrophysiology and stabilizes the myocardial cell membrane to prevent fatal arrhythmias. Insulin with dextrose shifts potassium intracellularly, while potassium-binding resin removes potassium from the body; neither is the first-line agent for membrane stabilization.
在兩地臨床實務中，鈣劑給予均需在嚴密心電圖監測下進行，以防高血鈣之相關心律不整。