一位尿崩症病人，護理師應監測下列哪種電解質不平衡？

尿崩症（diabetes insipidus）是一種因抗利尿激素（antidiuretic hormone, ADH）分泌不足或腎臟對其反應異常，導致腎臟無法有效濃縮尿液，進而排出大量稀釋的尿液。這種情況會造成體內水分的快速流失，血液中的水分相對減少，導致血液變得濃縮。當血液濃縮時，血漿中的鈉離子濃度會相對升高，引起高血鈉（hypernatremia）。因此，護理師應密切監測病人的血清鈉濃度，以及其他與脫水和電解質失衡相關的指標，如血清滲透壓、尿液滲透壓、體重變化和意識狀態。高血鈉可能導致嚴重的神經系統症狀，如煩躁不安、意識模糊甚至昏迷。 臨床思路：此題考量病理生理學的理解與電解質平衡。理解尿崩症的核心病理（水分流失）是判斷電解質變化的關鍵。高血鈉是此疾病最直接且重要的電解質異常。

Diabetes insipidus is caused by inadequate secretion of antidiuretic hormone (ADH) or by abnormal renal response to ADH, leaving the kidneys unable to concentrate urine effectively and producing large volumes of dilute urine. This rapid loss of body water relatively reduces the water content of the blood, making it more concentrated. As the blood becomes concentrated, the plasma sodium level rises proportionally, producing hypernatremia. Therefore, the nurse must closely monitor serum sodium as well as other indicators related to dehydration and electrolyte imbalance, such as serum osmolality, urine osmolality, weight changes, and level of consciousness. Hypernatremia can produce severe neurologic symptoms, including restlessness, confusion, and even coma. Clinical reasoning: This item tests understanding of pathophysiology and electrolyte balance. Understanding the core pathology of diabetes insipidus (water loss) is the key to predicting electrolyte changes. Hypernatremia is the most direct and important electrolyte abnormality in this disease.