— 生理適應 · MEDIUM · MCQ —
慢性腎臟病病人血鉀濃度為 6.2 mEq/L，護理師應預期心電圖出現何種變化？
A client with chronic kidney disease (CKD) has a serum potassium level of 6.2 mEq/L. Which ECG change should the nurse anticipate?
- AFlattened T wavesT波平坦
- BProlonged QT intervalQT間期延長
- CTall, peaked T waves✓ 正解高大尖銳的T波
- DU wavesU波
— Explanation · 中文詳解 —
高血鉀（Hyperkalemia）會影響心肌的再極化過程。當血鉀濃度超過 6.0 mEq/L，心電圖常見的早期特徵為 T 波高尖（Tall, peaked T waves）。若進一步惡化，會導致 PR 間期延長、QRS 波變寬，甚至出現心室顫動或心跳停止。其他選項則與低血鉀較相關。
Hyperkalemia affects myocardial repolarization. When serum K exceeds 6.0 mEq/L, the early ECG hallmark is tall, peaked T waves. With worsening hyperkalemia, the PR interval prolongs, the QRS widens, and ventricular fibrillation or asystole may follow. The other options are more associated with hypokalemia or calcium/magnesium disturbances.
✦ 台美臨床差異
美國護理師常依據 Protocol 在高血鉀時給予 Calcium Gluconate，台灣則需由醫師開立醫囑。