— 生理適應 · HARD · MCQ —
一位慢性腎臟病（CKD）病人血鉀濃度為 6.2 mEq/L。護理師預期醫療團隊會開立哪種藥物？
A client with chronic kidney disease (CKD) has a potassium level of 6.2 mEq/L. Which medication should the nurse anticipate the provider to order?
- ACalcium gluconate✓ 正解葡萄糖酸鈣
- BRegular insulin常規胰島素
- CSodium polystyrene sulfonate聚苯乙烯磺酸鈉
- DFurosemide速尿
— Explanation · 中文詳解 —
當鉀離子達 6.2 mEq/L 且可能影響心律時，首要目標是穩定心肌細胞膜。葡萄糖酸鈣（Calcium gluconate）無法降鉀，但可穩定心肌膜，防止致死性心律不整。胰島素（B）與聚苯乙烯磺酸鈉（C）是用於降鉀的藥物，但急性危急處置優先穩定心跳。
When the potassium level reaches 6.2 mEq/L and may compromise cardiac rhythm, the primary goal is to stabilize the myocardial cell membrane. Calcium gluconate does not lower serum potassium but stabilizes cardiac membranes and prevents lethal dysrhythmias. Insulin (B) and sodium polystyrene sulfonate (C) are used to lower potassium, but acute emergency management gives priority to stabilizing the heart.
✦ 台美臨床差異
美國護理師常依據緊急 Protocol 直接給予 Calcium gluconate；台灣則多需由醫師評估心電圖變化後開立醫囑。