— 照護管理 · MEDIUM · MCQ —
護理師照護一位預備接受血液透析的慢性腎臟病第五期（CKD stage 5）病人，哪項透析前評估最關鍵？
A nurse is caring for a client with chronic kidney disease (CKD) stage 5 who is preparing for hemodialysis. Which pre-dialysis assessment is most critical?
- AWeigh the client稱量病人體重
- BCheck the patency and condition of the AV fistula or graft✓ 正解檢查動靜脈廔管或人工血管的通暢性及狀況
- CReview the client's recent potassium level檢視病人最近的鉀離子濃度
- DAssess lung sounds for crackles評估肺部是否有囉音
— Explanation · 中文詳解 —
血液透析依賴血管通路（AVF/AVG）來引流和回輸血液。確保血管通路通暢且無感染跡象，是安全有效進行透析的前提。若通路有問題，可能導致透析失敗或嚴重併發症。其他選項雖重要，但通路狀況是透析操作的直接前置條件。
Assessing the patency and condition of the arteriovenous fistula or graft is the most critical pre-dialysis step because hemodialysis relies entirely on functional vascular access for safe blood flow. While weight, potassium levels, and lung sounds are important for overall management, vascular access integrity is the primary prerequisite for initiating treatment.
✦ 台美臨床差異
美國的腎臟照護團隊（包含腎臟科醫師、透析護理師、營養師）合作緊密；台灣的團隊合作模式類似，但部分地區資源可能較集中，病人需至特定大型醫院。