一位病人因高血壓正在服用 spironolactone。護理師應建議病人避免選用下列哪種食物？

Spironolactone 是一種保鉀利尿劑（Potassium-sparing diuretic），它在遠端小管拮抗醛固酮（aldosterone），促使鈉排泄但保留鉀離子。服用此類藥物的病人面臨高血鉀（Hyperkalemia）的風險，因此飲食衛教的重點在於限制高鉀食物。香蕉（D）是著名的高鉀食物（每根約含 400mg 鉀），應儘量避免或嚴格限量。蘋果（B）、白吐司（C）和四季豆（A）的鉀含量相對較低，通常不需刻意禁忌。護理師必須確保病人理解藥物機轉與飲食的交互作用，以避免心律不整等嚴重併發症。此外，也應提醒病人避免使用含鉀的代鹽（salt substitutes）。

Spironolactone is a potassium-sparing diuretic that antagonizes aldosterone at the distal tubule, promoting sodium excretion while retaining potassium. Patients on this medication are at risk for hyperkalemia, so dietary teaching focuses on limiting high-potassium foods. Bananas (D) are a well-known high-potassium food (approximately 400 mg of potassium per banana) and should be avoided or strictly limited. Apples (B), white bread (C), and green beans (A) are relatively low in potassium and generally do not need to be specifically restricted. The nurse must ensure the patient understands the interaction between the drug's mechanism and dietary intake to avoid serious complications such as dysrhythmias. The patient should also be cautioned against using potassium-containing salt substitutes.

美國飲食中常有『代鹽』（Salt Substitutes），其主要成分是氯化鉀，護理師會特別強調這點。台灣民眾則常吃深綠色蔬菜湯或喝果汁，護理師需針對這類高鉀來源進行衛教。