一位被診斷為高血鈉的病人。護理師應質疑哪項輸液醫囑？

高血鈉（Hypernatremia）的核心病理是細胞外液滲透壓過高，導致水分從細胞內移至細胞外，造成細胞脫水。治療原則是使用低滲透壓（Hypotonic）溶液來稀釋血鈉並補充細胞內液。0.9%生理食鹽水是等滲透壓溶液，其鈉濃度（154 mEq/L）與血漿接近，無法有效稀釋過高的血鈉，甚至可能在心腎功能不佳的病人身上增加鈉負荷。護理師應質疑此醫囑，因為它無法達成治療高血鈉的目標。

The core pathophysiology of hypernatremia is an excessively high extracellular osmolality, which draws water out of cells and causes cellular dehydration. The treatment principle is to use a hypotonic solution to dilute serum sodium and replace intracellular fluid. 0.9% normal saline is isotonic; its sodium concentration (154 mEq/L) is close to that of plasma, so it cannot effectively dilute elevated serum sodium and may even increase the sodium load in clients with compromised cardiac or renal function. The nurse should question this order because it does not achieve the treatment goal for hypernatremia.