— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師正給予萬古黴素（vancomycin）的靜脈輸注。病人同時也服用呋塞米（furosemide）。護理師應最密切監測哪種電解質不平衡？
A nurse is administering an IV infusion of vancomycin. The client also takes furosemide. Which electrolyte imbalance should the nurse monitor for most closely?
- AHyperkalemia高血鉀症
- BHypernatremia高血鈉症
- CHyponatremia低血鈉症
- DHypokalemia✓ 正解低血鉀症
— Explanation · 中文詳解 —
Vancomycin 與 Furosemide 同時使用會增加耳毒性（ototoxicity）與腎毒性（nephrotoxicity）的風險。Furosemide 作為袢利尿劑（loop diuretic），會導致腎小管排鉀增加，引起低血鉀（hypokalemia）。低血鉀會增加毛地黃毒性，並影響神經肌肉功能，故需密切監測血鉀濃度。
The concurrent use of vancomycin and furosemide increases the risk of ototoxicity and nephrotoicity, with furosemide specifically causing significant potassium loss through its loop diuretic action. Hypokalemia is the primary electrolyte imbalance to monitor, as low potassium levels can exacerbate cardiac risks and neuromuscular dysfunction while potentially increasing susceptibility to digoxin toxicity.