護理師為一位因高血壓開始服用螺內酯（Spironolactone）的病人進行衛教。病人的哪些陳述表示需要進一步指導？（選所有適合的）
The nurse is providing teaching to a client starting spironolactone for hypertension. Which statements by the client indicate a need for further teaching? (Select all that apply.)
- AI should increase my intake of bananas and orange juice✓ 正解我應該增加香蕉和柳橙汁的攝取
- BI will use a salt substitute to reduce my sodium intake✓ 正解我會使用代鹽來減少鈉的攝取
- CI should call the doctor if I feel weak or have heart palpitations如果我感到虛弱或有心悸，我應該打電話給醫生
- DI need to weigh myself once a month✓ 正解我需要每月稱一次體重
- EI should rise slowly from a sitting or lying position我應該從坐姿或臥姿緩慢站起
Spironolactone 是一種保鉀利尿劑（Potassium-sparing diuretic）。其核心副作用是高血壓（Hyperkalemia）。因此，病人「不應該」增加富含鉀的食物如香蕉、柳橙汁（A），也不應使用含鉀的「代鹽」（Salt substitutes）（B），因為這會導致血鉀危險升高。此外，體重監控應是「每日」而非每月（D），以精確評估水腫情形。C 是正確的行為，因為心悸與虛弱是高血壓的徵兆。E 也是正確的，因為利尿劑會導致姿勢性低血壓。這題考的是對「保鉀」機轉的理解及其對飲食的具體限制。
Spironolactone is a potassium-sparing diuretic. Its key adverse effect is hyperkalemia. Therefore, the client should not increase intake of potassium-rich foods such as bananas or orange juice (A), and should also avoid potassium-containing salt substitutes (B), since these would cause serum potassium to rise to dangerous levels. In addition, weight monitoring should be daily rather than monthly (D) so that fluid status can be accurately assessed. C is correct behavior, since palpitations and weakness are signs of hyperkalemia. E is also correct, since diuretics may cause orthostatic hypotension. This item tests understanding of the 'potassium-sparing' mechanism and its specific dietary restrictions.
美國 NCLEX 非常強調「代鹽（Salt substitute）」這個陷阱，因為美國市售代鹽幾乎都是鉀鹽；台灣病人較少使用代鹽，但需額外提醒「低鈉鹽」或「健康鹽」在台灣也常含高鉀，這是兩地衛教的共同點。