— 藥理與非經腸給藥 · MEDIUM · MCQ —
病人因心臟衰竭處方服用螺內酯（Spironolactone）。護理師應包含哪項衛教內容？
A client is prescribed spironolactone for heart failure. Which instruction should the nurse include in the teaching?
- AIncrease intake of bananas and citrus fruits增加香蕉和柑橘類水果的攝取
- BTake the medication before bedtime睡前服用藥物
- CLimit the use of salt substitutes✓ 正解限制使用代鹽
- DExpect a decrease in urine output預期尿量減少
— Explanation · 中文詳解 —
Spironolactone 是保鉀利尿劑。鹽代用品（Salt substitutes）通常含有高濃度的氯化鉀，與此藥併用會導致高血鉀危險。病人應維持正常的鉀攝取量，而非額外增加（如香蕉、柑橘）。為避免夜尿干擾睡眠，利尿劑應在白天服用。
Spironolactone is a potassium-sparing diuretic. Salt substitutes typically contain high concentrations of potassium chloride; using them with spironolactone can cause dangerous hyperkalemia. Patients should maintain a normal potassium intake (not increase intake of bananas or citrus). To avoid nocturia disrupting sleep, diuretics should be taken in the daytime.
✦ 台美臨床差異
美國非常強調「代鹽」的衛教，因為美國超市代鹽產品多樣；台灣代鹽使用率相對較低，但仍需注意低鈉鹽中的鉀含量。