— 生理適應 · MEDIUM · MCQ —
一位慢性腎臟病病人出現肌肉無力與心悸，心電圖顯示 T 波高尖。護理師預期醫師會開立哪種藥物？
A client with chronic kidney disease (CKD) reports muscle weakness and palpitations. The ECG shows peaked T-waves. Which medication should the nurse anticipate?
- ASodium polystyrene sulfonate聚苯乙烯磺酸鈉
- BCalcium gluconate葡萄糖酸鈣
- CRegular insulin and dextrose✓ 正解常規胰島素和葡萄糖
- DFurosemide呋塞米
— Explanation · 中文詳解 —
高血鉀症（Hyperkalemia）在慢性腎臟病（CKD）病人中極為常見，因為腎臟無法有效排鉀。高尖 T 波為心電圖典型徵象，顯示心肌電生理受到干擾，具生命威脅。胰島素搭配葡萄糖（Regular insulin and dextrose）是臨床上降低血鉀最迅速的急救手段，能促使鉀離子從血液迅速移入細胞內，從而暫時降低血鉀濃度以預防致命性心律不整。
Hyperkalemia is common in CKD because the kidneys cannot excrete potassium effectively. Peaked T waves are a classic ECG sign indicating disturbed cardiac electrophysiology and risk of fatal arrhythmias. Regular insulin with dextrose is the fastest way to acutely lower potassium by shifting it intracellularly, temporarily reducing the level and preventing dysrhythmias.