病人服用螺內酯（Spironolactone），護理師應評估什麼？

螺內酯（Spironolactone）為醛固酮拮抗劑（Aldosterone antagonist），屬於保鉀利尿劑。其機轉是透過抑制遠曲小管和集尿管的醛固酮受體，促進鈉與水排出，同時保留鉀離子。由於藥物會顯著增加血清鉀濃度，使用期間最嚴重的併發症為高血鉀（Hyperkalemia），可能導致致命性心律不整。因此，護理師應將監測血清電解質視為首要任務。

Spironolactone is an aldosterone antagonist and a potassium-sparing diuretic. Its mechanism is to inhibit aldosterone receptors in the distal convoluted tubule and collecting duct, promoting sodium and water excretion while retaining potassium. Because the drug significantly increases serum potassium concentration, the most serious complication during use is hyperkalemia, which may lead to fatal dysrhythmias. Therefore, the nurse must regard monitoring serum electrolytes as the top priority.