— 生理適應 · MEDIUM · MCQ —
肝硬化個案的下列哪項實驗室數據，護理師應優先報告給醫療團隊？
Which lab result in a client with cirrhosis should the nurse prioritize reporting to the healthcare provider?
- ASerum albumin 3.2 g/dL血清白蛋白 3.2 g/dL
- BALT 45 U/LALT 45 U/L
- CPlatelets 120,000/mm³血小板 120,000/mm³
- DAmmonia 110 mcg/dL✓ 正解氨 110 mcg/dL
— Explanation · 中文詳解 —
肝硬化病人因肝功能受損，無法將氨代謝為尿素。高血氨會穿透血腦屏障導致肝性腦病變（Hepatic Encephalopathy），表現為意識改變。相較於其他數據，氨濃度過高具有神經毒性，威脅個案安全，需優先處理。
An ammonia level of 110 mcg/dL should be prioritized because elevated ammonia can cross the blood-brain barrier and cause hepatic encephalopathy, leading to altered mental status. While low albumin, mild ALT elevation, and thrombocytopenia are common findings in cirrhosis due to liver dysfunction and hypersplenism, hyperammonemia presents an immediate neurological threat.
✦ 台美臨床差異
美國護理師常透過標準化評估量表（如 West Haven criteria）主動監測腦病變；台灣臨床則較依賴醫師判斷。