— 藥理與非經腸給藥 · HARD · SATA —
一位病人開始服用碳酸鋰（Lithium）。護理師應提供哪些優先的衛教指導？（選所有適合的）
A client is started on lithium carbonate. Which nursing instructions are priority for client education? (Select all that apply.)
- AMaintain a consistent sodium intake✓ 正解維持一致的鈉攝取量
- BDrink 2 to 3 liters of fluids daily✓ 正解每日飲用2至3公升液體
- CRestrict intake of caffeinated beverages限制含咖啡因飲料的攝取
- DReport symptoms of hand tremors or diarrhea✓ 正解報告手顫抖或腹瀉的症狀
- ETake the medication with meals to reduce GI irritation✓ 正解隨餐服藥以減少胃腸道刺激
— Explanation · 中文詳解 —
鋰鹽治療指數窄，體內鈉濃度會影響鋰的代謝。低鈉飲食會導致鋰滯留造成中毒，因此需保持恆定的鈉攝取。每日充足水分（2-3L）可預防脫水導致的鋰濃度上升。震顫與腹瀉是早期中毒跡象，需告知病人注意。隨餐服用可減少腸胃不適，但不影響藥效。
Lithium has a narrow therapeutic index, and body sodium influences lithium metabolism. Low sodium intake causes lithium retention and toxicity, so consistent sodium intake is essential. Adequate fluids (2-3 L/day) prevent dehydration-related lithium elevation. Hand tremors and diarrhea are early signs of toxicity that must be reported. Taking with meals reduces GI irritation. Caffeine restriction (C) is not a priority lithium teaching point.
✦ 台美臨床差異
美台對鋰鹽監測均重視，但台灣臨床護理師常需更主動提醒病人避開非類固醇抗發炎藥（NSAIDs），因其會顯著減少鋰鹽排泄。