一位慢性腎臟病患主訴肌肉無力與心悸。護理師應優先檢視哪項檢驗結果？
A client with chronic kidney disease (CKD) reports muscle weakness and palpitations. Which lab result should the nurse review first?
- ASerum potassium✓ 正解血清鉀
- BHemoglobin血紅素
- CSerum calcium血清鈣
- DSerum creatinine血清肌酸酐
慢性腎臟病患常有高血鉀（Hyperkalemia），典型症狀包括肌肉無力、麻木、心律不整（心悸）。高血鉀對心臟傳導系統具威脅性，可能導致致命性心律不整。肌酐酸（D）與血紅素（B）雖重要，但非造成急性心悸的主因。鈣（C）雖與磷鉀相關，但優先級次於鉀。
Hyperkalemia is the most common life-threatening electrolyte abnormality in CKD because failing kidneys cannot excrete potassium. The combination of muscle weakness and palpitations strongly suggests hyperkalemia and warrants immediate review of serum potassium because of the risk of fatal arrhythmia (peaked T waves, widened QRS, VF). Creatinine and hemoglobin remain abnormal in CKD but do not cause acute palpitations; calcium imbalance is important but secondary to potassium in this acute presentation.
美台臨床皆重視 CKD 的高血鉀預警，美國護理師常主動監測 ECG 變化。