— 生理適應 · EASY · MCQ —
一位慢性腎臟病（CKD）病患，血清肌酸酐為 4.5 mg/dL。護理師應建議哪項飲食調整？
A client with chronic kidney disease (CKD) has a serum creatinine of 4.5 mg/dL. Which dietary modification should the nurse recommend?
- AIncrease dietary calcium intake增加膳食鈣攝取量
- BRestrict potassium and phosphorus intake✓ 正解限制鉀和磷的攝取
- CIncrease protein intake to promote healing增加蛋白質攝取以促進癒合
- DLimit fluid intake to 500 mL per day將液體攝取量限制為每天 500 mL
— Explanation · 中文詳解 —
慢性腎臟病惡化時,腎臟排泄代謝廢物與電解質的功能下降。高血鉀與高血磷常隨之發生,因此需嚴格限制攝取。增加蛋白質反而會增加代謝廢物(尿素氮)堆積;水分限制視尿量而定,500 mL 過於嚴苛且非初期建議。
Clients with chronic kidney disease require dietary modifications to restrict potassium and phosphorus, as impaired renal function leads to dangerous accumulations of these electrolytes. Increasing protein intake would worsen azotemia by adding to the nitrogenous waste burden, while fluid restriction must be individualized based on urine output rather than applying a rigid limit.
✦ 台美臨床差異
美國透過 RD (Registered Dietitian) 進行深度衛教；台灣護理師在慢性病管理衛教中扮演較多樣的角色。