— 生理適應 · MEDIUM · MCQ —
一位急性胰臟炎病人禁食並接受靜脈輸液。護理師評估發現 Trousseau 徵象呈陽性。這代表哪種電解質不平衡？
A client with acute pancreatitis is NPO and receiving IV fluids. The nurse assesses the client and notes a positive Trousseau's sign. Which electrolyte imbalance is indicated?
- AHyponatremia低血鈉
- BHypomagnesemia低血鎂
- CHypocalcemia✓ 正解低血鈣
- DHypokalemia低血鉀
— Explanation · 中文詳解 —
Trousseau 徵象（測量血壓時出現腕痙攣）與 Chvostek 徵象均為低血鈣的特異性表現。急性胰臟炎常因脂肪壞死與鈣離子結合而導致低血鈣。此為臨床常見的神經肌肉過度興奮表現，護理師應警覺此現象並監測心律不整。
Trousseau's sign is a classic indicator of neuromuscular irritability caused by hypocalcemia. In acute pancreatitis, fat necrosis leads to the binding of calcium ions, resulting in low serum calcium levels. Nurses must monitor for this sign as it reflects significant electrolyte imbalance.
✦ 台美臨床差異
美國醫護對於檢驗數據異常的臨床徵象評估非常重視；台灣臨床較依賴抽血報告結果作為處置依據。