— 生理適應 · MEDIUM · MCQ —
護理師照護一位尿崩症病患。下列哪項護理措施對於維持病患水分平衡最優先？
A nurse is caring for a client with diabetes insipidus. Which intervention is the priority for the client's fluid balance?
- AAssessing the client for peripheral edema評估病人是否有周邊水腫
- BAdministering desmopressin acetate✓ 正解給予醋酸去氨加壓素
- CMonitoring urine output and specific gravity監測尿液排出量和比重
- DEncouraging a high-sodium diet鼓勵高鈉飲食
— Explanation · 中文詳解 —
尿崩症主因抗利尿激素分泌不足或對其無反應，導致大量稀釋尿液排出。Desmopressin 是人工合成的 ADH 類似物，直接處理病理機制（減少尿量）。監測尿量固然重要，但藥物治療是解決高滲透壓脫水危機的根本。
Desmopressin acetate is the priority intervention because it replaces the deficient antidiuretic hormone, directly addressing the underlying pathophysiology of diabetes insipidus to reduce excessive urine output. While monitoring urine output and specific gravity is essential for assessment, it does not correct the fluid imbalance. Administering a high-sodium diet would worsen dehydration, and peripheral edema is unlikely due to significant fluid loss.
✦ 台美臨床差異
美國護理師對 desmopressin 給藥路徑（鼻噴劑 vs IV）需根據醫囑判斷，台灣臨床較多使用 IV 或皮下給藥。