哪項評估指標最能代表低血容性休克患者的輸液復甦有效？
Which assessment finding is the most reliable indicator of effective fluid resuscitation in a client with hypovolemic shock?
- AUrine output of 30 mL/hr✓ 正解尿量 30 mL/hr
- BHeart rate of 80 bpm心率 80 bpm
- CCentral venous pressure of 5 mmHg中心靜脈壓 5 mmHg
- DBlood pressure of 110/70 mmHg血壓 110/70 mmHg
尿量是反映組織灌流與腎臟功能最敏感的指標。休克時，為了維持重要器官灌流，腎臟會減少過濾，尿量減少（少尿）。當輸液復甦成功，組織灌流改善，尿量會恢復至 >30 mL/hr。BP 與 HR 雖重要，但可能受藥物或代償機制影響，而非器官灌流的直接指標。
Urine output is the most sensitive indicator of tissue perfusion and renal function. During shock, in order to maintain perfusion of vital organs, the kidneys reduce filtration, resulting in decreased urine output (oliguria). When fluid resuscitation is successful and tissue perfusion improves, urine output returns to >30 mL/hr. Blood pressure and heart rate are important but may be influenced by medications or compensatory mechanisms and do not directly reflect organ perfusion.
美台臨床皆重視尿量，但美國護理師常依據特定輸液醫囑目標，更主動調整給予速度。