— 生理適應 · MEDIUM · MCQ —
一位急性胰臟炎病患主訴嚴重上腹痛並放射至背部，護理師應密切監測哪項檢驗值以評估全身性併發症？
A client with acute pancreatitis presents with severe epigastric pain radiating to the back. Which laboratory value should the nurse monitor most closely for systemic complications?
- ASerum calcium✓ 正解血清鈣
- BWhite blood cell count白血球計數
- CSerum lipase血清脂肪酶
- DSerum amylase血清澱粉酶
— Explanation · 中文詳解 —
急性胰臟炎常見脂肪壞死，釋出的脂肪酸會與鈣離子結合形成鈣皂，導致低血鈣，進而引發 tetany 或心律不整等嚴重併發症。澱粉酶與脂肪酶是用於診斷的指標，白血球增高代表發炎，但低血鈣對病患生命安全威脅更大，需優先監測。
Fat necrosis in acute pancreatitis releases fatty acids that bind with calcium ions to form calcium soaps, resulting in hypocalcemia and potentially severe complications such as tetany or cardiac dysrhythmia. Amylase and lipase are diagnostic markers, and an elevated white blood cell count indicates inflammation, but hypocalcemia poses a greater threat to the client's life and must be prioritized for monitoring.
✦ 台美臨床差異
美台臨床皆重視低血鈣的監測與處理，但在台灣醫囑常會預防性補充鈣劑，美國則更依賴實驗室報告。