護理師對一位剛開始服用鋰鹽（Lithium Carbonate）治療雙極性疾患的病人進行衛教。下列哪些發言顯示病人需要進一步的衛教？（選所有適合的）
A nurse is teaching a client who has been newly prescribed lithium carbonate for bipolar disorder. Which statement by the client indicates a need for further teaching? (Select all that apply.)
- AI will restrict my salt intake to lower my blood pressure✓ 正解我會限制鹽分攝取以降低血壓
- BI will drink 2 to 3 liters of fluid every day我每天會喝 2 到 3 公升的液體
- CI should take ibuprofen if I develop a mild headache✓ 正解如果我出現輕微頭痛，我會服用布洛芬
- DI will have my blood levels checked regularly我會定期檢查血液濃度
- EI will stop taking the medication if I feel fine✓ 正解如果我覺得感覺良好，我會停止服藥
鋰鹽（Lithium）的衛教極具挑戰性，因為它的治療視窗窄且受鈉離子平衡顯著影響。核心概念：鋰離子與鈉離子在腎臟競爭排泄。若病人『限制鈉鹽攝取』（選項 A），腎臟會誤將鋰離子保留以補足離子平衡，導致鋰中毒。Ibuprofen 等 NSAIDs（選項 C）會降低腎血流量，減少鋰的清除率，顯著增加中毒風險，頭痛應改用 Acetaminophen。長期精神科用藥不可因症狀緩解擅自停藥（選項 E）。正確的行為應是維持穩定的鈉鹽攝取、充足的水分（選項 B，預防脫水導致的鋰濃度上升）以及定期抽血監測（選項 D，治療濃度約 0.6-1.2 mEq/L）。本題考點在於『藥物-電解質交互作用』與『藥物-藥物交互作用』。
Teaching about lithium is challenging because of its narrow therapeutic window and its strong dependence on sodium balance. The core concept is that lithium and sodium compete for renal excretion. If the client restricts sodium intake (option A), the kidneys retain lithium to compensate for the sodium deficit, causing lithium toxicity. NSAIDs such as ibuprofen (option C) reduce renal blood flow and decrease lithium clearance, significantly increasing the risk of toxicity; acetaminophen should be used for headache instead. Long-term psychiatric medications should not be discontinued on the client's own once symptoms improve (option E). The correct behaviors are to maintain a consistent sodium intake, adequate hydration (option B, to prevent dehydration-induced increases in lithium concentration), and regular blood-level monitoring (option D, with a therapeutic level of approximately 0.6 to 1.2 mEq/L). The teaching focus of this item is on drug-electrolyte and drug-drug interactions.
在美國，鋰鹽病人的管理常包含詳細的飲食衛教手冊，強調穩定鈉攝取的重要性。台灣臨床衛教有時較著重於副作用（如手抖、多尿）的觀察，對於 NSAIDs 交互作用以及鈉離子穩定性的強調程度在各醫院間可能有所差異。