— 降低風險 · HARD · MCQ —
護理師照護一位高鉀血症病人，下列哪項診斷檢查為優先？
A nurse is caring for a client with hyperkalemia. Which diagnostic test is the priority?
- AArterial blood gas (ABG)動脈血液氣體分析 (ABG)
- BSerum creatinine level血清肌酸酐濃度
- CElectrocardiogram (ECG)✓ 正解心電圖 (ECG)
- DComplete blood count (CBC)全血細胞計數 (CBC)
— Explanation · 中文詳解 —
高鉀血症直接威脅心臟電生理活動。心電圖變化（如 T 波高尖、PR 間期延長、QRS 波變寬）是判斷心律不整風險的最快指標，這比檢測腎功能或酸鹼平衡更具備生命救急的指標意義。優先執行 ECG 可即時判斷是否需立即給予鈣劑以保護心肌。
Hyperkalemia directly threatens cardiac electrophysiologic activity. Electrocardiogram (ECG) changes (such as peaked T waves, prolonged PR interval, and widened QRS complex) are the most rapid indicators for assessing the risk of arrhythmia, and they carry greater life-saving significance than tests of renal function or acid-base balance. Performing an ECG first allows immediate determination of whether calcium must be given urgently to protect the myocardium.
✦ 台美臨床差異
美國醫院針對嚴重高鉀常有 Standing Order 即時給予 Calcium Gluconate，台灣則需醫師評估心電圖後開立。