— 生理適應 · HARD · SATA —
下列哪些護理措施適合診斷為抗利尿激素分泌失調症候群 (SIADH) 的病患？（選所有適合的）
Which of the following interventions are appropriate for a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)? (Select all that apply.)
- ARestrict daily fluid intake✓ 正解限制每日液體攝取量
- BAdminister hypertonic saline IV✓ 正解靜脈輸注高張食鹽水
- CEncourage a high-salt, high-protein diet✓ 正解鼓勵攝取高鹽、高蛋白飲食
- DMonitor daily weights✓ 正解監測每日體重
- EProvide an isotonic saline IV infusion提供等張食鹽水靜脈輸注
— Explanation · 中文詳解 —
SIADH 特徵為水過多與稀釋性低血鈉。護理重點在於限水、補充電解質（高張食鹽水）以防腦水腫。監測體重可快速判斷體液滯留狀況。等張食鹽水（E）對於 SIADH 患者可能導致更嚴重的稀釋性低血鈉，應避免。
SIADH causes water retention and dilutional hyponatremia, making fluid restriction essential to prevent further sodium dilution. Hypertonic saline may be administered to correct severe hyponatremia, while a high-salt, high-protein diet helps increase serum osmolality. Daily weights are monitored as the most reliable indicator of fluid status, whereas isotonic saline is contraindicated as it worsens hyponatremia.
✦ 台美臨床差異
美國醫院有嚴格 SIADH 限水 Protocol，台灣護理師常需額外與醫師溝通確認是否執行限水。