— 生理適應 · HARD · SATA —
護理師評估疑似抗利尿激素分泌失調症（SIADH）的病人，預期會看到哪些實驗室數據？（選所有適合的）
A nurse is assessing a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory findings should the nurse anticipate? (Select all that apply.)
- ASerum sodium 125 mEq/L✓ 正解血清鈉 125 mEq/L
- BSerum osmolality 260 mOsm/kg✓ 正解血清滲透壓 260 mOsm/kg
- CUrine specific gravity 1.035✓ 正解尿液比重 1.035
- DSerum potassium 5.5 mEq/L血清鉀 5.5 mEq/L
- EUrine sodium 150 mEq/L尿液鈉 150 mEq/L
— Explanation · 中文詳解 —
SIADH 導致水分滯留，造成稀釋性低血鈉及血清滲透壓下降。同時，因為身體排出濃縮尿液，尿液比重會上升（>1.030）。選項 E 雖在某些 SIADH 病人可見高尿鈉，但臨床上常規診斷重點在於稀釋性血鈉過低與尿液濃縮，選項 A、B、C 為最典型的特徵。
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) causes water retention, leading to dilutional hyponatremia and decreased serum osmolality. The kidneys excrete concentrated urine in response to ADH, resulting in a high urine specific gravity. These findings distinguish SIADH from other conditions affecting fluid balance.
✦ 台美臨床差異
SIADH 的管理在兩地皆重於水分限制，但美國護理師對 fluid balance 的監測及醫囑執行彈性較大。