— 生理適應 · MEDIUM · MCQ —
護理師照顧一位高血鉀病人,應優先注意哪種心電圖(ECG)改變?
A nurse is caring for a client with hyperkalemia. Which ECG finding should the nurse prioritize?
- AU wavesU 波
- BFlattened P wavesP 波平坦
- CProlonged QT intervalQT 間期延長
- DTall, peaked T waves✓ 正解高聳尖銳的 T 波
— Explanation · 中文詳解 —
高血鉀會影響心肌去極化與再極化過程。初期心電圖變化為高聳的 T 波(Tall, peaked T waves),若不處理會演變為 PR 間期延長、QRS 波變寬,甚至造成致死性心律不整(如心室顫動)。
Hyperkalemia affects myocardial depolarization and repolarization, with tall, peaked T waves being the earliest electrocardiographic sign. If untreated, this progresses to prolonged PR intervals, widened QRS complexes, and potentially fatal arrhythmias such as ventricular fibrillation.
✦ 台美臨床差異
美國 ICU/急診護理師常需依據心電圖異常直接執行除顫或給藥流程;台灣較強調先通知醫師確認。