— 藥理與非經腸給藥 · HARD · MCQ —
護理師正照護一位因糖尿病酮酸血症（DKA）而接受靜脈注射常規胰島素（regular insulin）的病人。哪項發現需要立即的護理介入？
A nurse is caring for a client receiving regular insulin intravenously for diabetic ketoacidosis (DKA). Which finding requires immediate nursing intervention?
- AUrine ketones are moderate尿酮呈中度陽性
- BArterial pH of 7.25動脈血pH值為7.25
- CBlood glucose of 180 mg/dL血糖為180 mg/dL
- DSerum potassium of 3.0 mEq/L✓ 正解血清鉀為3.0 mEq/L
— Explanation · 中文詳解 —
治療糖尿病酮酸血症（DKA）時，靜脈注射胰島素會促使鉀離子從細胞外液轉移至細胞內，導致血鉀濃度下降。低血鉀（Hypokalemia）會嚴重干擾心肌傳導系統，增加致命性心律不整的風險。臨床上，在給予胰島素前，必須確保病人的血鉀數值在安全範圍（通常 > 3.3 mEq/L），若數值過低，必須優先補鉀，否則直接給予胰島素會加劇低血鉀，造成心臟驟停。
Insulin therapy drives potassium into cells, which can cause life-threatening hypokalemia. A serum potassium level of 3.0 mEq/L is critically low and requires immediate intervention, such as holding insulin and administering potassium replacement, to prevent fatal cardiac arrhythmias.