— 藥理與非經腸給藥 · HARD · MCQ —
病人醫囑給予靜脈推注利尿劑呋塞米 40 mg。護理師觀察到下列何者顯示有潛在不良反應？
A client is prescribed furosemide 40 mg IV push. Which observation by the nurse indicates a potential adverse effect?
- ADecreased edema水腫減少
- BIncreased urine output尿量增加
- CWeight loss of 0.5 kg體重減輕 0.5 kg
- DDizziness upon standing✓ 正解站立時頭暈
— Explanation · 中文詳解 —
呋塞米（Furosemide）是強效環利尿劑，其作用機轉是抑制腎小管對鈉和氯的再吸收，導致大量水分與電解質流失。若靜脈推注（IV push）速度過快或利尿效果太強，會造成循環血容量急遽減少，引發姿勢性低血壓（Orthostatic hypotension）。病人站立時感到頭暈，是血容量不足的典型臨床表現，必須警覺。
Furosemide is a potent loop diuretic that inhibits sodium and chloride reabsorption in the renal tubules, leading to substantial loss of water and electrolytes. If given by IV push too rapidly, or if the diuretic effect is too strong, circulating volume can drop sharply and produce orthostatic hypotension. Dizziness when the client stands is a classic clinical manifestation of inadequate volume and requires close attention.