— 生理適應 · EASY · MCQ —
一位嚴重脫水的病人正在接受靜脈輸液。何項發現表明輸液復甦是有效的？
A client with severe dehydration is receiving intravenous fluids. Which finding indicates that fluid resuscitation is effective?
- AUrine output of 20 mL/hr尿量每小時20毫升
- BHeart rate decreases from 120 to 90 bpm✓ 正解心率從每分鐘120次降至90次
- CBlood pressure of 80/40 mmHg血壓80/40 mmHg
- DSkin turgor remains poor皮膚彈性依然不佳
— Explanation · 中文詳解 —
脫水時，心率會代償性增加。當輸液有效，血容量恢復，心率會下降。心率從 120 降至 90 bpm 表示情況改善。尿量 20 mL/hr 仍太少；血壓 80/40 mmHg 仍偏低；皮膚彈性差表示脫水仍持續。
During dehydration, heart rate increases as a compensatory response. When fluid resuscitation is effective and blood volume is restored, heart rate decreases. A decrease from 120 to 90 bpm indicates improvement. A urine output of 20 mL/hr is still too low; a blood pressure of 80/40 mmHg remains low; and poor skin turgor suggests ongoing dehydration.
✦ 台美臨床差異
美國急診室常使用中心靜脈導管（CVC）來監測和給予大量輸液；台灣亦同，但可能依醫院設備和病人狀況決定。