— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師照顧一位因妊娠毒血症接受硫酸鎂點滴的病人。下列哪些臨床表現屬於硫酸鎂中毒徵象？（選所有適合的）
A nurse is caring for a client receiving an infusion of magnesium sulfate for preeclampsia. Which findings should the nurse identify as signs of magnesium toxicity? (Select all that apply.)
- ARespiratory rate of 10 breaths/min✓ 正解呼吸頻率為每分鐘 10 次
- BAbsent patellar deep tendon reflexes✓ 正解膝腱反射消失
- CSerum magnesium level of 3.5 mEq/L血清鎂濃度為 3.5 mEq/L
- DUrinary output of 20 mL/hr✓ 正解尿量為每小時 20 mL
- EHypotension✓ 正解低血壓
— Explanation · 中文詳解 —
硫酸鎂中毒的三大核心指標包含呼吸抑制、深部肌腱反射消失及尿量減少。硫酸鎂主要經由腎臟排泄，尿量過低會導致藥物蓄積中毒。血中濃度需高於 4-7 mEq/L 才達治療範圍，故 3.5 mEq/L 屬治療不足而非中毒。
Signs of magnesium toxicity include respiratory depression (rate less than 12 breaths/min), absent deep tendon reflexes, oliguria (urine output less than 30 mL/hr), and hypotension. These findings indicate that magnesium levels are dangerously high, impairing neuromuscular function and renal excretion. A serum level of 3.5 mEq/L is subtherapeutic and does not indicate toxicity.
✦ 台美臨床差異
美國常依據 protocol 停藥並備妥葡萄糖酸鈣；台灣臨床醫師下醫囑後，護理師需嚴格執行每小時監測。