護理師查看一位服用碳酸鋰（Lithium Carbonate）病人的檢驗結果。鋰濃度為 1.8 mEq/L。哪項行動為優先？
The nurse is reviewing the lab results of a client taking Lithium Carbonate. The level is 1.8 mEq/L. Which action is the priority?
- AEncourage the client to drink more water鼓勵病人多喝水
- BDocument the finding as within therapeutic range將發現記錄為在治療範圍內
- CAdminister the next scheduled dose給予下一劑預定劑量
- DNotify the physician immediately✓ 正解立即通知醫師
碳酸鋰（Lithium Carbonate）是一種情緒穩定劑，主要用於治療雙相情感障礙（bipolar disorder）。它具有非常窄的治療濃度範圍，通常介於 0.6 至 1.2 mEq/L。這表示即使血清濃度略微超過治療範圍，也可能迅速達到中毒水平，引發嚴重的副作用。 當鋰濃度達到 1.8 mEq/L 時，這已經超出治療範圍並進入中毒水平。鋰中毒的症狀包括噁心、嘔吐、腹瀉、震顫、嗜睡、肌肉無力、共濟失調（ataxia），嚴重時可能導致癲癇、心律不整、昏迷甚至死亡。因此，護理師在發現鋰濃度過高時，首要且最緊急的行動是立即通知醫師，以便及時調整治療方案，可能需要停藥、補充電解質或進行透析，以避免更嚴重的併發症，確保病人生命安全。
Lithium carbonate is a mood stabilizer used primarily for bipolar disorder. It has a very narrow therapeutic range, generally 0.6 to 1.2 mEq/L, meaning that even small elevations above this range can quickly produce toxic levels and serious adverse effects. A lithium level of 1.8 mEq/L is above the therapeutic range and within the toxic range. Symptoms of lithium toxicity include nausea, vomiting, diarrhea, tremor, drowsiness, muscle weakness, and ataxia, and may progress to seizures, arrhythmias, coma, and death. Therefore, when the nurse detects an elevated lithium level, the priority and most urgent action is to notify the physician immediately so that the treatment plan can be adjusted promptly. The drug may need to be withheld, electrolytes replaced, or dialysis initiated to prevent further complications and ensure client safety.