— 降低風險 · MEDIUM · MCQ —
護理師為雙相情緒障礙症病人進行碳酸鋰衛教。哪項指導對於預防鋰鹽中毒至關重要？
A nurse is teaching a client about lithium carbonate for bipolar disorder. Which instruction is crucial to prevent lithium toxicity?
- ALimit fluid intake to 1 liter per day將液體攝取量限制在每天 1 公升
- BMaintain a low-sodium diet維持低鈉飲食
- CEnsure adequate sodium and fluid intake✓ 正解確保足夠的鈉和液體攝取
- DTake the medication only when feeling manic僅在感到躁症發作時服藥
— Explanation · 中文詳解 —
碳酸鋰 (Lithium carbonate) 是一種治療雙相情緒障礙症 (bipolar disorder) 的常用藥物，但其治療窗狹窄，容易發生毒性。鋰鹽在腎臟的排泄與鈉離子密切相關。當體內鈉離子不足或脫水時，腎臟會增加對鈉和鋰的重吸收，導致血中鋰鹽濃度升高，進而引發鋰鹽中毒。因此，維持足夠的鈉和水分攝取是預防鋰鹽中毒的關鍵衛教內容，以確保鋰鹽在體內能正常代謝和排泄，維持穩定的血中濃度。
Adequate sodium and fluid intake is crucial to prevent lithium toxicity because lithium is excreted by the kidneys in a manner similar to sodium. Dehydration or low sodium levels cause the kidneys to reabsorb more lithium, leading to elevated serum concentrations and potential toxicity, so maintaining stable hydration and electrolyte balance is essential.