一位慢性腎臟病（CKD）病人血鉀 6.8 mEq/L 且有心電圖變化。哪種藥物用於穩定心肌細胞膜？
A client with Chronic Kidney Disease (CKD) has a serum potassium of 6.8 mEq/L and ECG changes. Which medication is given to stabilize the cardiac membrane?
- ASodium bicarbonate碳酸氫鈉
- BInsulin and D50W胰島素與50%葡萄糖
- CSodium polystyrene sulfonate (Kayexalate)聚苯乙烯磺酸鈉（Kayexalate）
- DCalcium gluconate✓ 正解葡萄糖酸鈣
當血鉀濃度高達 6.8 mEq/L 且伴隨心電圖改變（如 T 波高聳、QRS 波變寬），病人已處於致命心律不整的極高風險中。葡萄糖酸鈣（Calcium gluconate）的主要作用是拮抗高鉀對心肌細胞膜的影響，提高心肌去極化的閾值，從而穩定心肌細胞膜，防止心室顫動。需注意，鈣劑並不會降低血鉀數值，後續必須依賴胰島素加葡萄糖、Kayexalate 或透析來移除體內多餘的鉀離子。
When the serum potassium reaches 6.8 mEq/L and is accompanied by ECG changes (such as peaked T waves and widened QRS complexes), the client is at very high risk of life-threatening cardiac dysrhythmias. The primary action of calcium gluconate is to antagonize the effects of high potassium on the cardiac cell membrane, raising the myocardial depolarization threshold and thereby stabilizing the cardiac membrane to prevent ventricular fibrillation. Note that calcium does not lower the serum potassium level; subsequent removal of excess potassium from the body requires insulin with glucose, Kayexalate, or dialysis.