— 生理適應 · EASY · MCQ —
一位病人被診斷為抗利尿激素分泌失調症候群（SIADH），下列哪項護理措施最適當？
A client is diagnosed with SIADH. Which nursing intervention is appropriate?
- AAdminister potassium supplements給予鉀離子補充劑
- BEncourage a high-sodium diet鼓勵高鈉飲食
- CIncrease oral fluid intake增加口服液體攝取
- DMonitor for fluid volume overload✓ 正解監測體積過載跡象
— Explanation · 中文詳解 —
SIADH 病人因為過度分泌 ADH，導致水分滯留、稀釋性低血鈉。核心護理措施為嚴格限水（Fluid restriction）以減輕體液負荷，避免進一步惡化低血鈉。選項 C 會加重病況；選項 A 無直接關聯；選項 B 雖然鈉離子低，但核心是限水而非單純補鈉。
Clients with SIADH require strict fluid restriction to manage water retention and prevent worsening hyponatremia. Monitoring for signs of fluid volume overload is essential, while increasing fluid intake would exacerbate the condition, and potassium supplements are not directly indicated for this disorder.
✦ 台美臨床差異
美國醫院常見護理師嚴格執行水份攝取限制的圖表記錄；台灣通常依據醫囑執行，較少由護理師主導限水強度。