護理師正在照護一位尿崩症（DI）病人。哪項評估發現最令人擔憂？
A nurse is caring for a client with diabetes insipidus (DI). Which assessment finding is most concerning?
- AClient reports excessive thirst病人主訴過度口渴
- BSerum sodium level of 160 mEq/L✓ 正解血清鈉濃度為160 mEq/L
- CUrine specific gravity of 1.002尿液比重為1.002
- DUrine output of 300 mL/hour尿液排出量為300 mL/小時
尿崩症（DI）的主要問題是抗利尿激素（ADH）不足或腎臟對其反應不良，導致腎臟無法濃縮尿液，排出大量稀釋尿。若病人同時有大量飲水，血鈉可能維持正常；但若飲水量不足以彌補排尿量，則會導致血鈉顯著升高（hypernatremia），這是危及生命的狀況。尿量多、尿比重低是 DI 的特徵，但血鈉升高是緊急狀況。
The main problem in diabetes insipidus (DI) is insufficient antidiuretic hormone (ADH) or poor renal response to it, leading to the kidneys' inability to concentrate urine and excretion of a large volume of dilute urine. If the patient is drinking large amounts of water, serum sodium may remain normal; however, if water intake fails to keep up with urine output, serum sodium can rise markedly (hypernatremia), a life-threatening condition. Large urine volume and low urine specific gravity are characteristic of DI, but elevated serum sodium is an emergency.
美國的內分泌科會依循嚴謹的指引來處理高血鈉，強調緩慢糾正；台灣的照護也重視此點，但病人對飲水量的自我監測與回報非常重要。