長期臥床病人有發生腎結石的風險。其主要原因是什麼？
A client on long-term bed rest is at risk for renal calculi. What is the primary cause?
- ADecreased fluid intake by the client病人液體攝取量減少
- BExcessive intake of calcium-rich foods過量攝取富含鈣質的食物
- CStasis of urine in the bladder膀胱內尿液滯留
- DDemineralization of bones due to lack of weight-bearing✓ 正解因缺乏負重活動導致的骨骼脫鈣
本題探討長期臥床（long-term bed rest）病人發生腎結石（renal calculi）風險的生理機轉。核心概念是缺乏負重活動對骨骼代謝的影響。當身體長期處於臥床狀態時，骨骼缺乏應力刺激，會導致骨質脫鈣（demineralization of bones）現象，即鈣質從骨骼中釋放到血液中，造成高血鈣症（hypercalcemia）。這些過量的鈣質隨後經由腎臟排出，增加了尿液中鈣離子的濃度，進而提高了草酸鈣結石形成的風險。護理師需了解此機轉，以便採取預防措施，如鼓勵活動、足夠水分攝取和必要時的藥物治療。
This item explores the physiologic mechanism behind renal calculi risk in clients on long-term bed rest. The core concept is the effect of weight-bearing absence on bone metabolism. With prolonged immobility, bones lack mechanical stress and demineralization occurs—calcium is released from bones into the blood, producing hypercalcemia. The excess calcium is excreted by the kidneys, raising urinary calcium concentration and increasing the risk of calcium oxalate stone formation. Nurses should understand this mechanism so they can promote mobility, ensure adequate fluid intake, and use pharmacologic therapy when indicated.