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藥理與非經腸給藥 · EASY · MCQ

護理師監測一位正在接受靜脈滴注硫酸鎂(Magnesium Sulfate)的病人。哪項評估結果最令人擔憂?

The nurse is monitoring a client receiving an IV infusion of Magnesium Sulfate. Which assessment finding is most concerning?

  • ARespiratory rate 10 breaths/min✓ 正解
    呼吸速率 10 次/分
  • BUrine output 50 mL/hr
    尿量 50 mL/時
  • CFlushing and feeling warm
    臉部潮紅且感覺溫熱
  • DDeep tendon reflexes +1
    深腱反射 +1
Explanation · 中文詳解

硫酸鎂(Magnesium Sulfate)常用於治療子癇前症(preeclampsia)和子癇(eclampsia)以預防或控制癲癇發作,以及治療低血鎂症和某些心律不整。然而,鎂離子是一種中樞神經系統(central nervous system, CNS)抑制劑,過量會導致嚴重的副作用,甚至危及生命。 護理師在監測接受硫酸鎂靜脈滴注的病人時,必須密切觀察是否有鎂中毒的徵兆。鎂中毒的典型表現包括深腱反射(deep tendon reflexes, DTR)減弱或消失、呼吸抑制(respiratory depression)、尿量減少(oliguria)以及心臟傳導阻滯。這些症狀的出現提示血清鎂濃度過高,尤其是呼吸抑制,這直接影響病人的生命安全,是需要立即處理的緊急情況。因此,呼吸速率降至每分鐘 10 次是極為令人擔憂的評估結果,需要立即介入。

Magnesium sulfate is commonly used to treat preeclampsia and eclampsia for the prevention or control of seizures, as well as to treat hypomagnesemia and certain dysrhythmias. However, magnesium is a central nervous system (CNS) depressant, and overdose can produce severe, even life-threatening, adverse effects. When caring for a patient receiving an IV infusion of magnesium sulfate, the nurse must closely observe for signs of magnesium toxicity. Classic manifestations include diminished or absent deep tendon reflexes (DTR), respiratory depression, oliguria, and cardiac conduction block. The appearance of these signs indicates an excessive serum magnesium level; in particular, respiratory depression directly threatens the patient's life and is an emergency that requires immediate intervention. A respiratory rate that drops to 10 breaths per minute is therefore an extremely concerning assessment finding that requires immediate action.

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