— 生理適應 · EASY · MCQ —
病人診斷為急性胰臟炎。護理師應優先向醫師報告下列哪項血液檢查結果？
A patient is admitted with a diagnosis of acute pancreatitis. Which serum laboratory finding should the nurse prioritize to report to the provider?
- ASerum amylase of 500 U/L血清澱粉酶500 U/L
- BSerum lipase of 300 U/L血清脂肪酶300 U/L
- CWhite blood cell count of 12,000/mm³白血球計數12,000/mm³
- DSerum calcium of 7.0 mg/dL✓ 正解血清鈣7.0 mg/dL
— Explanation · 中文詳解 —
急性胰臟炎易引發低血鈣，這是由於脂肪壞死將鈣質結合，可能導致嚴重心律不整或抽搐。血鈣 < 8.5 mg/dL 屬於嚴重且需立即處理，血澱粉酶與脂肪酶升高為診斷指標，WBC 升高反映發炎，皆為預期內結果，優先級低於低血鈣。
Acute pancreatitis readily produces hypocalcemia because fat necrosis binds calcium, which may lead to serious dysrhythmias or seizures. A serum calcium of less than 8.5 mg/dL is severe and requires immediate management; elevations of amylase and lipase are diagnostic findings, and an elevated WBC count reflects inflammation. These are expected results and are of lower priority than hypocalcemia.
✦ 台美臨床差異
美國護理師在發現危急值（Critical Value）時需立即回報並記錄執行狀況；台灣則依醫院病安通報流程，常規通知醫師後記錄。