— 降低風險 · MEDIUM · MCQ —
護理師評估一名慢性腎臟病 (CKD) 病人。下列哪項實驗室數值需要立即通知醫療照護提供者？
A nurse is assessing a client with chronic kidney disease (CKD). Which of the following laboratory values requires immediate notification of the healthcare provider?
- APotassium 6.8 mEq/L✓ 正解鉀離子 6.8 mEq/L
- BCreatinine 3.5 mg/dL肌酸酐 3.5 mg/dL
- CHemoglobin 9.5 g/dL血紅素 9.5 g/dL
- DBUN 40 mg/dL血尿素氮 40 mg/dL
— Explanation · 中文詳解 —
慢性腎臟病 (CKD) 病人由於腎功能受損，排泄電解質的能力下降，特別容易發生高血鉀。血鉀濃度高於正常範圍 (3.5-5.0 mEq/L) 會對心臟電生理活動產生嚴重影響，導致心律不整，從心搏過緩、心室顫動到心搏停止，是危及生命的急症。因此，護理師在評估 CKD 病人時，一旦發現嚴重高血鉀，必須立即通知醫療照護提供者，以便迅速採取降鉀措施，如給予鈣劑保護心臟、胰島素葡萄糖輸注、利尿劑或透析等。
A potassium level of 6.8 mEq/L indicates severe hyperkalemia, which is a medical emergency due to the risk of life-threatening cardiac arrhythmias. While elevated creatinine, hemoglobin, and BUN are expected findings in chronic kidney disease, hyperkalemia requires immediate notification of the healthcare provider for urgent intervention such as calcium administration or dialysis.