— 生理適應 · MEDIUM · MCQ —
護理師照護一位急性腎損傷 (AKI) 病人。哪項發現提示潛在的併發症？
A nurse is caring for a client with acute kidney injury (AKI). Which finding indicates a potential complication?
- ABlood urea nitrogen (BUN) 50 mg/dL血液尿素氮 (BUN) 50 mg/dL
- BMild edema in the ankles腳踝輕微水腫
- CUrine output of 600 mL in 8 hours8 小時內尿量 600 mL
- DSerum potassium level of 5.5 mEq/L✓ 正解血清鉀濃度 5.5 mEq/L
— Explanation · 中文詳解 —
急性腎損傷時，腎臟排泄鉀離子的功能受損，容易導致高血鉀。血鉀 5.5 mEq/L 是輕度高血鉀，但對 AKI 病人而言是警訊，可能進一步惡化為危及生命的心律不整。其他選項的尿量、BUN 和水腫雖需監測，但 5.5 mEq/L 的血鉀是最需立即關注的。
In acute kidney injury, the kidneys' ability to excrete potassium is impaired, predisposing to hyperkalemia. A serum potassium of 5.5 mEq/L is mild hyperkalemia, but in a patient with AKI it is a warning sign that may progress to life-threatening dysrhythmias. Although the other options (urine output, BUN, and edema) need to be monitored, the serum potassium of 5.5 mEq/L requires the most immediate attention.
✦ 台美臨床差異
美國腎臟科護理師常使用電解質監測系統預警；台灣則依賴定期抽血和臨床觀察，對高血鉀的即時處理流程需加強。