— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位病人因高血壓服用螺內酯（Spironolactone）。護理師提供的哪項飲食指導最為重要？
A client is taking spironolactone for hypertension. Which dietary instruction is most important for the nurse to provide?
- ADrink at least 3 liters of water per day每天至少喝 3 公升的水
- BLimit intake of calcium-rich dairy products限制富含鈣的乳製品攝取
- CIncrease intake of high-potassium foods like bananas增加高鉀食物的攝取，如香蕉
- DAvoid salt substitutes containing potassium chloride✓ 正解避免含有氯化鉀的代鹽
— Explanation · 中文詳解 —
Spironolactone 是一種保鉀利尿劑，作用於遠曲小管以排鈉保鉀。服用此藥的病人有發生高血鉀（Hyperkalemia）的風險。許多低鈉鹽（代鹽）含有氯化鉀，若病人同時攝取代鹽與保鉀利尿劑，會導致血鉀過高，引發致命性心律不整。因此，避免含鉀代鹽是極為關鍵的衛教重點。
Spironolactone is a potassium-sparing diuretic that increases the risk of hyperkalemia. Patients must be instructed to avoid salt substitutes containing potassium chloride, as combining these with the medication can lead to dangerously high serum potassium levels and potentially fatal arrhythmias.
✦ 台美臨床差異
美國超市代鹽種類多且常見；台灣病人則較常接觸中藥或高鉀蔬果汁，衛教應因地制宜。