護理師照護一位高血鈉病人。應觀察到何種現象？

高血鈉（Hypernatremia）是指血液中鈉離子濃度異常升高，這通常代表身體處於相對脫水的狀態，細胞外液的滲透壓升高，導致水分從細胞內轉移到細胞外。 因此，最預期出現的評估發現是黏膜乾燥（dry mucous membranes）（B）。由於細胞外液滲透壓升高，身體會試圖從細胞內抽取水分以維持平衡，這也會導致細胞內水分減少，包括唾液腺細胞，進而減少唾液分泌，造成口乾舌燥。 選項 D（水腫）通常與鈉離子過多但同時伴隨水滯留有關，例如在心臟衰竭或腎臟疾病的病人身上。單純的高血鈉，若無其他合併症，不一定會導致水腫，反而常伴隨脫水。 選項 A（肌肉抽筋）雖然是電解質不平衡的常見症狀，但更常與低血鈉（hyponatremia）或低血鉀（hypokalemia）有關，而非高血鈉。 選項 C（尿量增加）在某些情況下可能發生，例如病人飲水過多，但高血鈉本身代表體內缺水，身體會傾向保留水分，尿量通常不會增加，反而可能因體內缺水而減少。 臨床思路（Fluid & Electrolyte Balance / Assessment）：高血鈉的核心病生理是相對脫水，評估時應著重尋找脫水的跡象。

Hypernatremia refers to an abnormally elevated serum sodium concentration, which usually represents a state of relative dehydration. The osmotic pressure of the extracellular fluid rises, causing water to shift from the intracellular to the extracellular compartment. Therefore, the most expected assessment finding is dry mucous membranes (B). Because the extracellular osmotic pressure rises, the body attempts to draw water out of the cells to maintain balance, which also reduces intracellular water, including in salivary gland cells, thereby decreasing saliva production and resulting in a dry mouth. Option D (edema) is typically associated with sodium excess accompanied by water retention, such as in clients with heart failure or renal disease. Pure hypernatremia, in the absence of other comorbidities, does not necessarily cause edema and is more often accompanied by dehydration. Option A (muscle cramps), although a common symptom of electrolyte imbalance, is more frequently associated with hyponatremia or hypokalemia, not hypernatremia. Option C (increased urinary output) may occur under certain conditions, such as when the client drinks excessively, but hypernatremia itself indicates body water deficit, and the body tends to retain water; urine output usually does not increase and may instead decrease due to the water deficit. Clinical reasoning (Fluid & Electrolyte Balance / Assessment): The core pathophysiology of hypernatremia is relative dehydration, and assessment should focus on signs of dehydration.