— 生理適應 · MEDIUM · MCQ —
病人因高血鉀入院,護理師應預期看到哪種心電圖改變?
A client is admitted with hyperkalemia. Which ECG change should the nurse anticipate?
- APresence of U waves出現 U 波
- BTall, peaked T waves✓ 正解高大尖銳的 T 波
- CProlonged QT intervalQT 間期延長
- DFlattened T wavesT 波平坦
— Explanation · 中文詳解 —
高血鉀(hyperkalemia)會顯著改變心肌細胞的去極化與再極化過程。鉀離子濃度的上升直接影響心肌細胞膜電位,導致心電圖(ECG)出現特徵性變化。早期變化為 T 波高尖(tall, peaked T waves),這是由於再極化過程異常加速所致。隨著鉀離子濃度進一步升高,會出現 PR 間期延長、QRS 波變寬,最終可能引發心室顫動(VF)或心跳停止。護理師必須熟悉此 ECG 特徵,以便在危急狀況發生前採取降鉀處理。
Hyperkalemia accelerates ventricular repolarization, which typically manifests on an electrocardiogram as tall, peaked T waves. Recognizing this early sign is crucial for the nurse to anticipate life-threatening dysrhythmias and initiate interventions to lower serum potassium levels.