— 生理適應 · HARD · 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 波高聳。應懷疑哪種電解質異常？
A client with chronic kidney disease (CKD) reports muscle weakness and palpitations. The ECG shows peaked T waves. Which electrolyte imbalance is likely present?
- AHypokalemia低血鉀
- BHyperkalemia✓ 正解高血鉀
- CHypercalcemia高血鈣
- DHyponatremia低血鈉
— Explanation · 中文詳解 —
高血鉀症（Hyperkalemia）在 CKD 病人中常見，心電圖特徵包括 T 波高聳（Peaked T waves）、PR 間期延長及 QRS 波變寬。低血鉀（A）則會導致 U 波出現及 ST 段下降。肌肉無力與心悸皆為高血鉀造成的電生理擾亂結果。
The client is likely experiencing hyperkalemia, a common electrolyte imbalance in chronic kidney disease characterized by peaked T waves on the ECG, muscle weakness, and palpitations. Hypokalemia typically presents with flattened T waves and prominent U waves, while hypercalcemia and hyponatremia do not produce this specific ECG pattern.
✦ 台美臨床差異
美國護理師常有權力在心電圖異常時直接執行靜脈採血檢查電解質，台灣則需由醫師開立檢查醫囑。