— 生理適應 · MEDIUM · MCQ —
一位患有心衰竭且服用利尿劑（furosemide）的病人，護理師應優先關注哪項檢驗數據？
Which lab finding should the nurse prioritize in a client with a history of heart failure taking furosemide?
- ABlood urea nitrogen level尿素氮水平。
- BSerum sodium level血清鈉水平。
- CHemoglobin level血紅素水平。
- DSerum potassium level✓ 正解血清鉀水平。
— Explanation · 中文詳解 —
Furosemide 屬於環利尿劑（Loop diuretic），會促使鉀離子大量隨尿液排出。低血鉀會增加心衰竭病人對地高辛（Digoxin）的敏感性，甚至誘發致命性心律不整，因此鉀離子監測為重中之重。其餘指標（鈉、BUN、血紅素）雖亦受影響，但對心律的急性影響不如鉀離子直接與危險。
Furosemide is a loop diuretic that promotes substantial urinary excretion of potassium. Hypokalemia increases the sensitivity of heart-failure patients to digoxin and can even precipitate life-threatening dysrhythmias, making potassium monitoring the top priority. Other parameters (sodium, BUN, hemoglobin) are also affected, but their acute impact on cardiac rhythm is neither as direct nor as dangerous as that of potassium.
✦ 台美臨床差異
台美臨床皆重視利尿劑與電解質平衡，但美國護理師在監測到低血鉀時，常能根據標準流程與醫師協調補充劑量，介入更為快速。