— 生理適應 · MEDIUM · MCQ —
一名急性胰臟炎病人主訴上腹痛並放射至背部，護理師應優先監測哪種電解質不平衡？
A client with acute pancreatitis reports severe epigastric pain radiating to the back. Which electrolyte imbalance should the nurse prioritize monitoring?
- AHypocalcemia✓ 正解低血鈣
- BHypomagnesemia低血鎂
- CHyperkalemia高血鉀
- DHyponatremia低血鈉
— Explanation · 中文詳解 —
急性胰臟炎時，壞死的胰臟組織會釋放脂肪酶，造成脂肪皂化作用（fat saponification），消耗大量血清鈣。低血鈣會引發神經肌肉興奮性增加，出現 Trousseau's 或 Chvostek's 徵象，嚴重時會造成心律不整或喉頭痙攣，危及生命，因此必須優先監測。
In acute pancreatitis, necrotic pancreatic tissue releases lipase, producing fat saponification that consumes large amounts of serum calcium. Hypocalcemia increases neuromuscular excitability and produces Trousseau's or Chvostek's signs; in severe cases it can cause dysrhythmias or laryngospasm and is life-threatening, so it must be monitored as a priority.
✦ 台美臨床差異
美台臨床皆重視胰臟炎病人的血鈣監測，但台灣護理師常需依據醫師開立的抽血單執行，美國則常根據 Nursing Protocol 主動評估。