— 生理適應 · MEDIUM · MCQ —
下列哪一位病人發生高血鉀的風險最高？
Which client is at the highest risk for developing hyperkalemia?
- AClient with an intestinal obstruction on nasogastric suction接受鼻胃管抽吸的腸阻塞個案
- BClient with chronic diarrhea慢性腹瀉個案
- CClient with congestive heart failure on loop diuretics接受環利尿劑治療的充血性心臟衰竭個案
- DClient with severe third-degree burns✓ 正解嚴重三度燒傷個案
— Explanation · 中文詳解 —
嚴重燒傷造成細胞組織廣泛性破壞，細胞內的鉀離子會大量釋放到細胞外液中，導致血清鉀濃度急劇升高。這是造成高血鉀的危險因子，且伴隨急性腎損傷的風險，極易致命。其他選項如利尿劑、NG 抽吸或腹瀉多與低血鉀相關。
Severe third-degree burns cause extensive tissue destruction, leading to the massive release of intracellular potassium into the bloodstream. This process significantly increases the risk of hyperkalemia, whereas conditions involving fluid loss or diuretic use typically predispose clients to hypokalemia.
✦ 台美臨床差異
燒傷病人的電解質監測在兩地皆為標準程序，但美國燒傷加護病房常有專屬護理規範與快速檢測設備。