— 生理適應 · HARD · MCQ —
病人入院檢測鉀離子濃度為 6.8 mEq/L。護理師應監測心電圖出現何種變化？
A client is admitted with a potassium level of 6.8 mEq/L. Which rhythm change should the nurse monitor for on the ECG?
- ADepressed ST segmentST 段壓低
- BTall, peaked T waves✓ 正解高大尖銳的 T 波
- CShortened QT intervalQT 間期縮短
- DProminent U waves明顯的 U 波
— Explanation · 中文詳解 —
高血鉀症（Hyperkalemia）會影響心肌細胞的去極化與再極化，ECG 最典型的早期變化是 T 波變得高尖（Peaked T waves）。嚴重時會導致 PR 間期延長、QRS 波群變寬，最終導致心室顫動或心搏停止。U 波常見於低血鉀；ST 段壓低亦非高血鉀特徵。
Hyperkalemia significantly affects cardiac conduction, with tall, peaked T waves being a classic early electrocardiogram finding. This change reflects the altered repolarization of myocardial cells due to elevated potassium levels. Other options like prominent U waves are associated with hypokalemia, while depressed ST segments and shortened QT intervals relate to different electrolyte imbalances or conditions.
✦ 台美臨床差異
美台臨床皆高度重視危急值通知（Critical Value），但美國強調護理師在發現 ECG 異常時需立即執行心臟監護與準備給予鈣劑的醫囑。