— 生理適應 · MEDIUM · MCQ —
一位慢性腎臟病（CKD）病患主訴虛弱無力，心電圖顯示 T 波高聳（peaked T-waves）。護理師預期會給予下列哪項藥物？
A client with chronic kidney disease (CKD) reports feeling very weak. The ECG shows peaked T-waves. Which medication should the nurse anticipate administering?
- ACalcium gluconate✓ 正解葡萄糖酸鈣
- BRegular insulin常規胰島素
- CSodium polystyrene sulfonate聚苯乙烯磺酸鈉
- DFurosemide速尿
— Explanation · 中文詳解 —
心電圖出現高聳 T 波為嚴重高血鉀的心臟毒性表現，首要目標是保護心肌。鈣劑（Calcium gluconate）能立即穩定心肌細胞膜，防止心律不整。胰島素（Regular insulin）雖能降低血鉀，但屬於後續降低血鉀的步驟，緊急首選為鈣劑保護心臟。
Peaked T waves on the ECG are a manifestation of the cardiac toxicity of severe hyperkalemia, and the foremost goal is to protect the myocardium. Calcium gluconate can immediately stabilize the myocardial cell membrane and prevent arrhythmias. Although regular insulin can lower serum potassium, it is a subsequent step in reducing potassium; the emergency first choice is calcium to protect the heart.
✦ 台美臨床差異
無明顯差異，處理高血鉀的急救步驟（急救車處置）全球一致。