— 生理適應 · MEDIUM · MCQ —
一位診斷為抗利尿激素分泌不當症候群 (SIADH) 的患者入院。護理師應預期哪項檢驗結果？
A client is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which laboratory result should the nurse expect?
- AIncreased hematocrit紅血球比容增加
- BSerum sodium 128 mEq/L✓ 正解血清鈉 128 mEq/L
- CUrine specific gravity 1.002尿液比重 1.002
- DSerum osmolality 310 mOsm/kg血清滲透壓 310 mOsm/kg
— Explanation · 中文詳解 —
SIADH 是由於 ADH 分泌過多，導致水分過度滯留，引發稀釋性低血鈉。預期結果包括低血鈉（<135）、低血透壓（<280）及高尿比重（>1.030，因為尿液濃縮）。B 為高滲透壓（見於 DI）；C 為低尿比重（見於 DI）；D 為血液濃縮表現，SIADH 會因水分過多而使 Hct 下降。
SIADH results from excessive ADH secretion causing water retention and dilutional hyponatremia. Expected findings include low serum sodium (<135), low serum osmolality (<280), and high urine specific gravity (>1.030, concentrated urine). D indicates high osmolality (seen in DI), C indicates dilute urine (DI), and A would suggest hemoconcentration; in SIADH, hematocrit actually falls due to dilution.
✦ 台美臨床差異
SIADH 與 DI 的鑑別診斷在 NCLEX 是高頻考點；台灣臨床多將此視為急重症照護重點。