— 生理適應 · HARD · SATA —
一位有原發性腎上腺功能不足（Addison's disease）病史的病人。預期會發現哪些徵象？（選所有適合的）
A nurse is assessing a client with a history of primary adrenal insufficiency (Addison's disease). Which findings are expected? (Select all that apply.)
- AHyperpigmentation of the skin✓ 正解皮膚色素沉著
- BHypotension✓ 正解低血壓
- CHyponatremia✓ 正解低血鈉
- DHyperglycemia高血糖
- EWeight gain體重增加
— Explanation · 中文詳解 —
Addison's 病因腎上腺皮質受損，缺乏糖皮質素與礦物皮質素。缺乏 cortisol 會使 ACTH 代償性升高，刺激黑色素沉積導致皮膚色素沉澱。缺乏 aldosterone 會導致低血鈉、低血壓、脫水。病人常有低血糖而非高血糖，體重會減輕而非增加。
Primary adrenal insufficiency results in cortisol and aldosterone deficiencies, leading to compensatory ACTH elevation that causes hyperpigmentation, and sodium loss that causes hyponatremia and hypotension. Clients typically present with weight loss and hypoglycemia rather than weight gain or hyperglycemia.
✦ 台美臨床差異
美台對 Addison's 危機的處理皆需給予壓力劑量的激素補充，病房照護觀念一致。