一位有心臟衰竭病史的患者因下肢水腫和呼吸困難入院。護理師注意到患者的血鉀值為 3.2 mEq/L。護理師應針對哪種藥物向醫療團隊進一步確認？
A client with a history of heart failure is admitted with dependent edema and dyspnea. The nurse notes the client's potassium level is 3.2 mEq/L. Which medication should the nurse clarify with the healthcare provider?
- AMetoprolol美托洛爾 (Metoprolol)
- BFurosemide✓ 正解呋塞米 (Furosemide)
- CSpironolactone螺內酯 (Spironolactone)
- DLisinopril貝那普利 (Lisinopril)
低血鉀（<3.5 mEq/L）是使用排鉀利尿劑（如 Furosemide）的主要禁忌或需謹慎監測的情況。Furosemide 會增加鉀離子排出，加重低鉀血症，可能引發心律不整或毛地黃中毒。Spironolactone 是保鉀利尿劑，Lisinopril（ACEI）通常會增加血鉀，故非首選確認對象。
Hypokalemia (<3.5 mEq/L) is a major contraindication or condition requiring careful monitoring when using potassium-wasting diuretics (such as furosemide). Furosemide increases potassium excretion, worsening hypokalemia and potentially precipitating dysrhythmias or digoxin toxicity. Spironolactone is a potassium-sparing diuretic, and lisinopril (an ACEI) generally raises serum potassium; therefore neither is the first medication to clarify.
美國 RN 需主動評估電解質並判斷是否暫緩給藥；台灣護理師亦需監測，但實務上多先通知醫師確認。