— 心理社會完整性 · MEDIUM · SATA —
護理師教導個案關於鋰鹽（Lithium carbonate）的副作用。個案應立即回報哪些症狀？（選所有適合的）
A nurse is teaching a client about the side effects of lithium carbonate. Which symptoms should the nurse instruct the client to report immediately? (Select all that apply.)
- AFine hand tremors手部細微震顫
- BCoarse tremors and ataxia✓ 正解粗大震顫與步態不穩
- CSevere diarrhea and vomiting✓ 正解嚴重腹瀉與嘔吐
- DIncreased thirst and frequent urination口渴增加與頻尿
- EConfusion or slurred speech✓ 正解意識模糊或口齒不清
— Explanation · 中文詳解 —
鋰鹽治療指數窄，極易中毒。細微手顫為常見副作用，但若惡化成粗大顫抖、步態不穩（Ataxia）、意識混亂或言語障礙，皆為中毒警訊。此外，導致脫水的腸胃道症狀（嘔吐、腹瀉）會降低鋰離子排泄，也需優先處理與監測。
Lithium has a narrow therapeutic index, so the nurse must instruct the client to report signs of toxicity immediately, including coarse tremors, ataxia, confusion, and slurred speech. Additionally, severe diarrhea and vomiting should be reported because fluid loss can lead to dehydration and increased lithium retention, precipitating toxicity.
✦ 台美臨床差異
鋰鹽監測在美台均為重點；台灣護理師通常會教導病人配合規律抽血監測濃度，美國則強調個案主動回報特定神經中毒徵兆。