— 生理適應 · HARD · MCQ —
一位代謝性酸中毒病人正在接受治療，護理師應監測治療過程中可能發生的電解質異常為何？
A client with metabolic acidosis is receiving treatment. Which electrolyte abnormality should the nurse monitor for during correction?
- AHypokalemia✓ 正解低血鉀症
- BHypernatremia高血鈉症
- CHypercalcemia高血鈣症
- DHypomagnesemia低血鎂症
— Explanation · 中文詳解 —
當代謝性酸中毒被碳酸氫鈉矯正時，氫離子會從細胞內移至細胞外，為了維持電中性，鉀離子會快速進入細胞內，導致血清鉀濃度下降。因此，在矯正酸中毒的過程中，必須嚴密監測血鉀變化，以預防醫源性低血鉀引起的風險。
When metabolic acidosis is corrected with sodium bicarbonate, hydrogen ions shift from the intracellular to the extracellular space, and to maintain electrical neutrality, potassium ions rapidly move into the cells, lowering the serum potassium level. Therefore, during correction of acidosis, serum potassium must be closely monitored to prevent iatrogenic hypokalemia and its associated risks.
✦ 台美臨床差異
美國護理指引強調酸鹼平衡與離子移動的關聯，台灣臨床對於此機制教育較偏向於實驗室數據監測。