— 生理適應 · HARD · MCQ —
護理師照護一位愛迪生氏病病人。生命徵象為：血壓 90/50 mmHg、心率 110 bpm、呼吸速率 24 次/分。哪項護理措施最適合？
A nurse is caring for a client with Addison's disease. The client's vital signs are: BP 90/50 mmHg, HR 110 bpm, RR 24 breaths/min. Which nursing intervention is most appropriate?
- AAdminister intravenous fluids and IV corticosteroids✓ 正解給予靜脈輸液及靜脈注射皮質類固醇
- BIncrease sodium intake增加鈉攝取
- CAdminister oral corticosteroids給予口服皮質類固醇
- DMonitor blood glucose levels closely密切監測血糖值
— Explanation · 中文詳解 —
病人出現低血壓、心搏過速，提示可能發生腎上腺危象。此時需立即給予靜脈輸液補充體液和血管內容量，並靜脈注射類固醇（如 hydrocortisone）來補充嚴重不足的皮質醇和醛固酮。口服類固醇作用較慢，單純增加鈉攝取不足以應對危象。
The client's hypotension and tachycardia suggest adrenal crisis. Immediate IV fluids restore intravascular volume, and IV corticosteroids (e.g., hydrocortisone) replace the severely deficient cortisol and aldosterone. Oral corticosteroids are too slow-acting; increasing sodium alone is insufficient to manage a crisis.
✦ 台美臨床差異
美國急診室有標準化腎上腺危象處理流程；台灣則依病人狀況和醫院資源，但快速給予 IV 輸液和類固醇是共同原則。