— 生理適應 · MEDIUM · MCQ —
護理師照護一名有心衰竭病史並靜脈滴注呋塞米（Furosemide）的病人。下列哪項發現是護理師最需監測的重點？
A nurse is caring for a client with a history of heart failure who is receiving an IV infusion of furosemide. Which finding is the most critical for the nurse to monitor?
- ABlood pressure of 110/70 mmHg血壓 110/70 mmHg
- BSlightly dry mucous membranes黏膜略為乾燥
- CUrine output of 50 mL/hour每小時尿量 50 mL
- DPotassium level of 2.8 mEq/L✓ 正解鉀離子濃度 2.8 mEq/L
— Explanation · 中文詳解 —
呋塞米屬於環利尿劑，會導致鉀離子隨尿液大量排出，進而引發低血鉀。血鉀 2.8 mEq/L 屬於嚴重低血鉀，極易引發嚴重心律不整甚至猝死。相較於正常的血壓或尿量，電解質不平衡對心臟功能的威脅最為直接且致命。
Furosemide is a loop diuretic that causes significant urinary potassium wasting and can precipitate hypokalemia. A potassium level of 2.8 mEq/L represents severe hypokalemia, which can readily provoke serious cardiac dysrhythmias and even sudden death. Compared with a normal blood pressure or urine output, electrolyte imbalance poses the most direct and lethal threat to cardiac function.
✦ 台美臨床差異
美國護理師常有權限依 lab 結果進行鉀補充建議；台灣通常需確認醫囑並進行藥物處方確認。