— 生理適應 · MEDIUM · SATA —
護理師照護一位剛診斷為低血鉀的病人。應監測哪些臨床表徵？（選所有適合的）
A nurse is caring for a client with a new diagnosis of hypokalemia. Which manifestations should the nurse monitor for? (Select all that apply.)
- AMuscle weakness✓ 正解肌肉無力
- BCardiac dysrhythmias✓ 正解心律不整
- CHyperactive bowel sounds腸鳴音亢進
- DFlattened T waves on ECG✓ 正解心電圖上 T 波平坦
- ETall, peaked T waves高聳尖銳的 T 波
— Explanation · 中文詳解 —
低血鉀影響神經肌肉傳導與心肌電生理。肌肉會出現無力與痙攣；心電圖特徵包括 T 波平坦或倒置及出現 U 波。腸胃道蠕動反而會減慢導致腸麻痺（而非活躍）。Tall, peaked T waves 是高血鉀的典型表現，非低血鉀徵象。
Hypokalemia affects neuromuscular conduction and cardiac electrophysiology. Muscles develop weakness and cramps, and the ECG shows flattened or inverted T waves and the appearance of U waves. Bowel motility slows, leading to ileus rather than hyperactivity. Tall, peaked T waves are the classic finding of hyperkalemia, not hypokalemia.
✦ 台美臨床差異
兩地護理師對低血鉀的判讀能力相當，美國 RN 依 protocol 補充鉀的彈性較大，台灣則需嚴格醫囑執行。