— 生理適應 · HARD · MCQ —
病人診斷為抗利尿激素分泌不當症候群（SIADH）。下列哪項護理措施最恰當？
A client is diagnosed with SIADH. Which nursing action is most appropriate?
- ARestrict fluid intake to 800-1000 mL daily✓ 正解將每日液體攝取量限制在 800-1000 mL
- BInitiate a fluid challenge of 1000 mL normal saline開始給予 1000 mL 生理食鹽水的液體挑戰
- CEncourage a high-sodium, low-protein diet鼓勵高鈉、低蛋白飲食
- DAdminister furosemide to reduce systemic edema給予呋塞米以減輕全身性水腫
— Explanation · 中文詳解 —
抗利尿激素分泌不當症候群（SIADH）的病理機轉為過多的 ADH 分泌導致水分滯留、細胞外液稀釋，進而引發稀釋性低血鈉。治療的核心目標是恢復血鈉濃度與減輕水分負荷。護理重點在於嚴格的水分限制（Fluid Restriction），以防止水分進一步累積導致腦水腫。給予生理食鹽水會增加血液容積，加劇稀釋程度，而利尿劑需在嚴格監測下使用，並非首選。
The primary nursing action for SIADH is restricting fluid intake to prevent further dilutional hyponatremia and cerebral edema. Administering fluid challenges like normal saline would exacerbate the condition by increasing blood volume and worsening hyponatremia. While sodium intake may be adjusted, fluid restriction remains the cornerstone of management to restore electrolyte balance.