— 生理適應 · HARD · MCQ —
一位急性腎損傷（AKI）病人發生電解質不平衡。護理師應優先監測何者以預防致命心臟事件？
A client with acute kidney injury (AKI) is experiencing electrolyte imbalance. Which finding should the nurse prioritize to prevent life-threatening cardiac events?
- AHypocalcemia低血鈣
- BHyperphosphatemia高血磷
- CHyponatremia低血鈉
- DHyperkalemia✓ 正解高血鉀
— Explanation · 中文詳解 —
急性腎損傷（AKI）導致腎臟無法維持電解質平衡。其中，高血鉀（hyperkalemia）是 AKI 最致命的併發症，因為過高的血鉀會直接干擾心肌電位傳導，導致心律不整、心室顫動甚至心跳停止。雖然低血鈣、高磷血症與低血鈉在 AKI 中也常見，但對心臟的急性致命威脅遠不及高血鉀。護理師應密切監測心電圖變化，並隨時準備給予降鉀藥物。
Hyperkalemia is the most critical electrolyte imbalance in acute kidney injury because it directly disrupts cardiac conduction, potentially leading to fatal arrhythmias. Although other imbalances occur, hyperkalemia poses the most immediate threat to life and requires urgent monitoring and intervention.