護理師正在照護一名有心臟衰竭病史且每日服用 Furosemide 的患者。下列哪項實驗室結果需要護理師立即進行介入處置？
A nurse is caring for a client with a history of heart failure who is taking furosemide daily. Which of the following laboratory results requires immediate intervention by the nurse?
- ASodium 136 mEq/L鈉 136 mEq/L
- BPotassium 2.8 mEq/L✓ 正解鉀 2.8 mEq/L
- CGlucose 110 mg/dL葡萄糖 110 mg/dL
- DCreatinine 1.1 mg/dL肌酸酐 1.1 mg/dL
Furosemide 是一種強效的環利尿劑（Loop diuretic），其最常見且危險的副作用是排出過多的鉀離子，導致低血鉀症。正常的血鉀範圍為 3.5-5.0 mEq/L，2.8 mEq/L 屬於嚴重低血鉀，會大幅增加心律不整（如心室顫動）以及 Digoxin 中毒的風險。心臟衰竭病人通常心肌較脆弱，低血鉀對其而言是致命的。鈉 136 位於正常下限（135-145），肌酸酐 1.1 屬於正常範圍（0.6-1.2），血糖 110 稍微偏高但不是急性緊急情況。臨床思路應為：利尿劑使用 → 監測電解質 → 識別極端偏差數值 → 預防性介入（如補充鉀鹽或通知醫師）。這是 Reduction of Risk Potential 領域中最基礎但也最重要的安全監測任務。
Furosemide is a potent loop diuretic; its most common and dangerous adverse effect is excessive potassium excretion leading to hypokalemia. The normal serum potassium range is 3.5-5.0 mEq/L, and a value of 2.8 mEq/L is severe hypokalemia that markedly increases the risk of cardiac arrhythmias (e.g., ventricular fibrillation) and digoxin toxicity. Sodium 136 is at the low end of normal (135-145), creatinine 1.1 is within normal range (0.6-1.2), and glucose 110 is mildly elevated but not an acute emergency. The clinical pathway is: diuretic use → monitor electrolytes → identify critical deviations → preventive intervention (potassium replacement or provider notification). This is a fundamental yet critical safety monitoring task in Reduction of Risk Potential.
在美國，這類危急值（Critical values）檢驗室會主動通知護理師，護理師必須在規定時間（如 15-30 分鐘）內確認並採取行動。在台灣，除了檢驗室通報外，護理師常需在醫囑系統中不斷重新整理（Refresh）畫面以捕捉最新數據，並依據醫師偏好的補鉀路徑（口服或靜脈）進行處置。