— 生理適應 · HARD · MCQ —
一位接受化療的病人被診斷為高血鉀，下列哪項評估發現需要立即通知醫師？
A client is diagnosed with hyperkalemia after receiving chemotherapy. Which assessment finding requires immediate notification of the healthcare provider?
- AMuscle cramping in the lower extremities下肢肌肉痙攣
- BSerum potassium level of 5.8 mEq/L血清鉀濃度為 5.8 mEq/L
- CNausea and abdominal cramping噁心與腹部絞痛
- DPresence of peaked T waves on the ECG✓ 正解心電圖上出現尖峰 T 波
— Explanation · 中文詳解 —
高血鉀會導致致命的心律失常。心電圖出現尖峰 T 波（peaked T waves）表示細胞膜電位已受顯著影響，若不及時處理，恐進展至心室顫動或心搏停止。相較於肌肉痙攣或電解質檢驗值，心電圖改變直接反映了心臟傳導系統的即時威脅，屬於緊急生理適應失調的徵象。
Peaked T waves on the ECG indicate critical cardiac instability and a high risk of fatal arrhythmias like ventricular fibrillation. This finding takes precedence over serum potassium levels or gastrointestinal symptoms because it reflects immediate threat to cardiac conduction.
✦ 台美臨床差異
美國護理師常有權依據 ECG 改變直接啟動緊急給藥流程；台灣通常需先報告醫師確認後開立處方。