一位病人因高血壓服用螺內酯（Spironolactone）。下列哪些飲食選擇顯示病人了解相關的預防措施？（選所有適合的）
A client is prescribed spironolactone for the treatment of hypertension. Which dietary choices indicate the client understands the necessary precautions? (Select all that apply.)
- AUsing a salt substitute containing potassium chloride使用含氯化鉀的代鹽
- BAvoiding large amounts of bananas and oranges✓ 正解避免大量食用香蕉和柳橙
- CLimiting the intake of spinach and broccoli✓ 正解限制菠菜和花椰菜的攝取
- DIncreasing intake of red meat and dairy增加紅肉和乳製品的攝取
- EDrinking at least 2 liters of water daily每天至少飲用 2 公升水
螺內酯是一種保鉀利尿劑，作用於遠曲小管與集尿管，抑制醛固酮。核心安全風險是高血鉀（Hyperkalemia）。正確的飲食衛教應聚焦於減少高鉀食物攝取。選項 B（香蕉、橘子）與選項 C（菠菜、花椰菜）皆屬高鉀食物，應適量限制。選項 A 錯誤是因為代鹽通常以氯化鉀代替鈉，會顯著增加血鉀濃度，對服用此藥的病人極度危險。選項 D 與 E 與該藥物副作用無直接因果關係。護理師必須強調血鉀過高會導致心律不整甚至心跳停止，因此飲食中的鉀離子監控是此類利尿劑治療成敗的關鍵。
Spironolactone is a potassium-sparing diuretic that acts on the distal tubule and collecting duct by antagonizing aldosterone. The core safety risk is hyperkalemia. Appropriate dietary teaching should focus on reducing intake of high-potassium foods. Option B (bananas and oranges) and option C (spinach and broccoli) are both high in potassium and should be limited. Option A is incorrect because salt substitutes typically replace sodium with potassium chloride, which can significantly elevate serum potassium and is extremely dangerous for clients taking this drug. Options D and E have no direct relationship with the drug's adverse effects. The nurse must emphasize that severe hyperkalemia can cause arrhythmias and even cardiac arrest, so monitoring dietary potassium is critical to the success of this diuretic therapy.
美國食品標籤會詳細標示鉀含量，且「Salt Substitute」在超市極為普遍，故衛教重點常放在代鹽。台灣民眾較常使用天然食材，衛教重點則多放在中藥、深色蔬菜與高鉀水果（如釋迦、香蕉）的攝取限制。