— 生理適應 · MEDIUM · MCQ —
一位慢性腎臟病病人主訴肌肉無力與心悸,心電圖顯示 T 波高尖。護理師應預期醫囑給予何種藥物?
A client with chronic kidney disease (CKD) reports muscle weakness and palpitations. The ECG reveals peaked T-waves. Which medication should the nurse anticipate?
- AFurosemide呋塞米 (Furosemide)
- BCalcium gluconate✓ 正解葡萄糖酸鈣 (Calcium gluconate)
- CDigoxin地高辛 (Digoxin)
- DSodium bicarbonate碳酸氫鈉 (Sodium bicarbonate)
— Explanation · 中文詳解 —
高血鉀症(Hyperkalemia)在慢性腎臟病人中常見,ECG 呈現高尖 T 波為典型危急徵象。葡萄糖酸鈣能穩定心肌細胞膜,防止致命性心律不整,是緊急處理首選。利尿劑雖可排鉀,但非緊急穩定心肌之用;毛地黃會因鉀離子紊亂引發毒性;碳酸氫鈉雖可用於調控酸鹼但效果較慢。
Calcium gluconate is the priority intervention for hyperkalemia with ECG changes because it stabilizes the cardiac cell membrane and prevents life-threatening arrhythmias. While other treatments help lower potassium levels, calcium acts immediately to protect the heart.
✦ 台美臨床差異
台美對於高血鉀緊急處理流程一致,皆優先給予鈣劑穩定心肌。