護理師正在照護一位肝硬化的病人。哪項實驗室發現提示肝臟合成功能受損？
A nurse is caring for a client with liver cirrhosis. Which laboratory finding suggests impaired synthetic function of the liver?
- ALow serum albumin level✓ 正解血清白蛋白濃度偏低
- BElevated alanine aminotransferase (ALT)丙胺酸胺基轉移酶 (ALT) 升高
- CIncreased prothrombin time (PT)凝血酶原時間 (PT) 延長
- DElevated direct bilirubin直接膽紅素升高
肝臟合成功能受損可由多項實驗室指標反映：B. 低血清白蛋白為慢性合成功能衰退的最直接指標（半衰期約 20 天，能反映數週至數月的合成趨勢）；C. PT 延長同樣反映合成功能（凝血因子半衰期較短，反映急性變化）。本題為單選題，「最直接反映慢性合成功能受損」以 B（白蛋白下降）較具特異性與標準性。其他選項：B. ALT 升高反映肝細胞損傷（cytotoxic injury），非合成；D. 直接膽紅素升高反映排泄功能異常，非合成。
Impaired hepatic synthetic function can be reflected by several laboratory indicators: B. Low serum albumin is the most direct indicator of chronic synthetic decline (albumin half-life is approximately 20 days and thus reflects synthesis trends over weeks to months); C. A prolonged PT also reflects impaired synthesis (the half-lives of clotting factors are shorter, so PT reflects acute changes). For this single-best-answer question, A (low albumin) is the most specific and standard indicator of chronic synthetic impairment. Regarding the other options: A. Elevated ALT reflects hepatocellular (cytotoxic) injury, not synthesis; D. Elevated direct bilirubin reflects impaired excretion, not synthesis.
美國有較多針對肝硬化病人的長期照護與營養支持指引，護理師常需與營養師協同評估；台灣的肝硬化照護也重視營養，但跨團隊合作的模式可能因醫院規模而異。