— 生理適應 · HARD · MCQ —
一位低血容性休克的病人正在接受靜脈輸液。哪個現象代表病人的灌流情況正在改善？
A client with hypovolemic shock is receiving IV fluids. Which sign indicates that the client's perfusion is improving?
- ASkin is pale and cool皮膚蒼白且冰冷
- BHeart rate 130 bpm心率130次/分鐘
- CUrine output 50 mL/hour✓ 正解尿量50毫升/小時
- DBlood pressure 80/50 mmHg血壓80/50 mmHg
— Explanation · 中文詳解 —
尿量是評估腎臟灌流與全身血液循環最敏感的臨床指標。當尿量大於 30-50 mL/hr，代表循環血量已充足，腎臟能進行過濾功能，是休克復甦成功的關鍵證據。其他選項如血壓低、心跳快、皮膚冷皆是休克持續的徵象。
Hypokalemia causes hyperpolarization of cell membranes, reducing neuromuscular excitability and leading to skeletal muscle weakness and decreased smooth muscle contraction in the gastrointestinal tract, resulting in diminished bowel sounds. Additionally, unstable cardiac membrane potentials can trigger various dysrhythmias, whereas tall peaked T waves are characteristic of hyperkalemia.
✦ 台美臨床差異
美台臨床對休克復甦的指標一致，但在重症照護時，美國護理師有時能依 Protocol 調整輸液速度。