— 藥理與非經腸給藥 · HARD · MCQ —
一位子癇前症病人正在接受硫酸鎂(Magnesium sulfate)輸注。哪項發現要求護理師立即停止輸注?
A client is receiving an infusion of Magnesium sulfate for preeclampsia. Which finding requires the nurse to stop the infusion immediately?
- AUrine output of 40 mL/hr尿量 40 mL/hr
- BAbsence of deep tendon reflexes✓ 正解深層肌腱反射消失
- CBlood pressure of 140/90 mmHg血壓 140/90 mmHg
- DRespiratory rate of 16 breaths/min呼吸頻率 16 次/分
— Explanation · 中文詳解 —
硫酸鎂中毒的首要臨床徵兆是深部腱反射消失(Patellar reflex),這是神經肌肉傳導受抑制的表現。若出現此情況,代表血中鎂濃度過高,有引發呼吸抑制與心跳停止的風險,必須立即停止輸注並備妥鈣劑(Calcium gluconate)作為解毒劑。
Absence of deep tendon reflexes is an early sign of magnesium toxicity, indicating that the serum magnesium level is dangerously high. This condition suppresses neuromuscular transmission and can progress to respiratory depression and cardiac arrest, requiring immediate cessation of the infusion and preparation of calcium gluconate as an antidote.
✦ 台美臨床差異
美台對於硫酸鎂監測原則一致,但在美國許多單位會使用電子監測儀器來確保滴速精準,台灣則常依賴護理師手動監測與紀錄。