一位有慢性心臟衰竭病史的病人正在接受靜脈注射呋塞米（Furosemide）。下列哪些發現顯示藥物有效？（選所有適合的）
A client with a history of chronic heart failure is receiving intravenous furosemide. Which of the following findings would indicate the medication is effective? (Select all that apply.)
- ADecrease in daily weight✓ 正解每日體重減輕
- BIncrease in serum potassium levels血清鉀濃度升高
- CReduced crackles in the lung bases✓ 正解肺底囉音減少
- DDecrease in peripheral edema✓ 正解周邊水腫減輕
- EIncrease in blood pressure血壓升高
呋塞米（Furosemide）是一種強力利尿劑，用於心臟衰竭以減少體內多餘的水分（前負荷）。評估其有效性的指標均與「排出液體」有關：1. 體重下降（A）是反映液體排除最精確的指標。2. 肺部囉音減少（C）說明肺水腫減輕，氣體交換改善。3. 外周水腫減輕（D）顯示間質組織液減少。選項 B 錯誤，因為 Furosemide 是排鉀利尿劑，會導致血鉀下降而非上升。選項 E 錯誤，大量利尿通常會導致血壓稍微下降或維持穩定，血壓上升並非利尿劑有效的表現，反而可能是液體過多的徵象。此題測驗對藥物藥理效果與副作用的全面評估。
Furosemide is a potent diuretic used in heart failure to reduce excess body fluid (preload). Indicators of effectiveness are all related to fluid excretion: 1. Decrease in body weight (A) is the most precise indicator of fluid loss. 2. Decreased crackles in the lung bases (C) indicates resolution of pulmonary edema and improved gas exchange. 3. Decreased peripheral edema (D) reflects reduced interstitial fluid. Option B is incorrect because Furosemide is a potassium-wasting diuretic and causes serum potassium to fall rather than rise. Option E is incorrect because vigorous diuresis usually leads to a slight decrease or stable blood pressure; a rise in blood pressure is not evidence of effectiveness and may instead suggest fluid overload. This question tests comprehensive assessment of both the pharmacologic effects and the side effects of the medication.
在美國 NCLEX 考試中，SATA 題型對於『排鉀』與『保鉀』利尿劑的區分極為常見。台灣臨床上護理師在給予 Lasix 後，除了觀察尿量（U/O），同樣會密切監測電解質與體重變化，但在衛教病人『每日量體重』的落實度上，美國門診追蹤系統較為結構化。