— 生理適應 · MEDIUM · MCQ —
一位患有慢性腎臟病 (CKD) 的病人因嚴重脫水入院。護理師最可能發現哪種電解質不平衡？
A client with a history of chronic kidney disease (CKD) is admitted with severe dehydration. Which electrolyte imbalance is the nurse most likely to find?
- AHypocalcemia✓ 正解低血鈣
- BHypophosphatemia低血磷
- CHyperkalemia高血鉀
- DHyponatremia低血鈉
— Explanation · 中文詳解 —
慢性腎臟病（CKD）病人常伴隨鈣磷代謝失調。因腎臟無法活化維生素 D，導致腸道鈣吸收減少；同時，腎功能受損導致磷排出減少，血磷升高（Hyperphosphatemia）。高血磷會與鈣結合形成磷酸鈣沉積於組織，進一步降低血中游離鈣濃度，導致低血鈣（Hypocalcemia）。嚴重脫水時，腎功能受損加劇，電解質不平衡更為明顯。
Chronic kidney disease impairs vitamin D activation and phosphorus excretion, leading to hyperphosphatemia. Elevated phosphorus levels bind with calcium, forming deposits that further reduce serum calcium, resulting in hypocalcemia. Severe dehydration exacerbates these metabolic imbalances by worsening renal function and electrolyte disturbances.