— 生理適應 · MEDIUM · MCQ —
護理師照護一位低鉀血症病人。下列哪項發現需優先回報醫師？
A nurse is caring for a client with hypokalemia. Which finding should the nurse recognize as a priority to report to the healthcare provider?
- AMuscle weakness in the legs腿部肌肉無力
- BReported constipation and abdominal distention主訴便秘與腹部脹氣
- CDecreased deep tendon reflexes深層肌腱反射減弱
- DIrregular heart rate and palpitations✓ 正解心律不整與心悸
— Explanation · 中文詳解 —
鉀離子（Potassium）在維持心肌細胞靜止電位與去極化過程中扮演關鍵角色。低鉀血症（Hypokalemia）會導致心肌興奮性增加與傳導異常，臨床上最危險的併發症是致命性心律不整（如心室顫動或心室頻脈）。在 NCLEX 的 ABC（Airway, Breathing, Circulation）護理優先順序原則下，循環系統的穩定性永遠是首要考量。心律不整直接威脅生命，必須優先回報醫師並準備心電圖監測與電解質補充。
Irregular heart rate and palpitations indicate cardiac arrhythmias, which are the most life-threatening complications of hypokalemia. According to ABC priorities, circulatory stability is paramount, so these signs require immediate reporting to the healthcare provider for potential electrocardiogram monitoring and electrolyte replacement.