— 生理適應 · MEDIUM · MCQ —
一位慢性腎臟病（CKD）病患血鉀為 5.8 mEq/L。護理師應預期醫師會開立哪種藥物？
A client with chronic kidney disease (CKD) has a serum potassium of 5.8 mEq/L. Which medication should the nurse anticipate the provider to prescribe?
- ASodium polystyrene sulfonate✓ 正解Sodium polystyrene sulfonate（聚苯乙烯磺酸鈉）
- BFurosemideFurosemide（呋塞米）
- CEpoetin alfaEpoetin alfa（重組人紅血球生成素）
- DCalcium carbonateCalcium carbonate（碳酸鈣）
— Explanation · 中文詳解 —
高血鉀是 CKD 常見併發症。Sodium polystyrene sulfonate (Kayexalate) 是一種陽離子交換樹脂，可透過消化道移除多餘的鉀離子。利尿劑在末期腎病效果有限，Epoetin alfa 用於治療貧血，鈣片用於控制磷，均非降血鉀首選。
Sodium polystyrene sulfonate is the appropriate medication to anticipate as it acts as a cation-exchange resin to remove excess potassium through the gastrointestinal tract. While diuretics may help, they are less effective in advanced renal failure, and other options like epoetin alfa or calcium carbonate address anemia and phosphorus binding, respectively, rather than hyperkalemia.
✦ 台美臨床差異
美國臨床已廣泛使用新型鉀結合劑如 Patiromer；台灣健保體系下仍以 Sodium polystyrene sulfonate 為主要用藥。