— 降低風險 · MEDIUM · MCQ —
護理師審閱一位新開立鋰鹽 (Lithium) 醫囑病人的用藥紀錄。哪項藥物應與醫師進一步確認？
The nurse is reviewing the medication record of a client with a new prescription for lithium. Which medication should the nurse clarify with the physician?
- ACiprofloxacin環丙沙星
- BAcetaminophen乙醯胺酚
- CMetformin美福明
- DHydrochlorothiazide (HCTZ)✓ 正解氫氯噻嗪 (HCTZ)
— Explanation · 中文詳解 —
鋰鹽與鈉離子在腎臟競爭排泄。利尿劑（特別是 Thiazide 類，如 HCTZ）會導致鈉流失，進而促使腎臟代償性地吸收更多鋰，導致鋰中毒風險大增。B、A、C 與鋰鹽血中濃度無直接重大交互作用。這是風險降低中關鍵的藥物安全考量。
Hydrochlorothiazide, a thiazide diuretic, can cause sodium depletion, which leads the kidneys to retain more lithium, significantly increasing the risk of lithium toxicity. The nurse must clarify this prescription with the provider to adjust the medication regimen safely.
✦ 台美臨床差異
美國 NCLEX 頻繁考鋰鹽中毒與利尿劑/NSAIDs 的關係；台灣臨床護理師亦需具備藥物交互作用警覺性。