護理師監測病人的心電圖顯示 T 波高尖。最可能是哪種電解質失調？
The nurse is monitoring a client with an EKG showing peaked T waves. Which electrolyte imbalance is most likely?
- AHyperkalemia✓ 正解高血鉀
- BHypocalcemia低血鈣
- CHypercalcemia高血鈣
- DHypokalemia低血鉀
心電圖 (EKG) 是診斷電解質失衡的重要工具，特別是對於影響心臟電生理活動的鉀離子。高血鉀 (hyperkalemia) 是血清鉀離子濃度異常升高 (>5.0 mEq/L) 的狀況，會對心臟產生一系列電生理影響。其中，T 波高尖 (peaked T waves) 是高血鉀最早期且典型的 EKG 變化之一。這是由於心室再極化 (ventricular repolarization) 速度加快和持續時間縮短所致。隨著血鉀水平進一步升高，EKG 可能會出現 PR 間期延長、QRS 波變寬，甚至 P 波消失，最終可能導致心室顫動 (ventricular fibrillation) 或心臟停搏。護理師應警覺這些 EKG 變化，並立即通知醫師，因為高血鉀是一種危及生命的緊急情況，需要迅速介入處理。
EKG is an important tool for diagnosing electrolyte imbalances, particularly those involving potassium, which affects cardiac electrophysiology. Hyperkalemia (serum potassium >5.0 mEq/L) produces a series of cardiac electrical effects. Peaked T waves are one of the earliest and most classic EKG changes of hyperkalemia, caused by faster and shorter ventricular repolarization. As serum potassium rises further, the EKG may show prolonged PR interval, widened QRS, loss of P waves, and eventually ventricular fibrillation or cardiac arrest. The nurse must recognize these changes and notify the physician immediately, as hyperkalemia is a life-threatening emergency requiring rapid intervention.
美國護理師被要求在看到 peaked T waves 時立即獲取 12 導程 EKG 並通報；台灣流程相似，但部分護理師可能先抽血確認血鉀值。