— 生理適應 · HARD · MCQ —
一位慢性腎臟病（CKD）病人血鉀濃度為 6.2 mEq/L，護理師預期醫囑會給予哪種藥物？
A client with chronic kidney disease (CKD) has a serum potassium of 6.2 mEq/L. Which medication should the nurse anticipate administering?
- ASodium polystyrene sulfonate✓ 正解聚苯乙烯磺酸鈉
- BSpironolactone螺內酯
- CFurosemide呋塞米
- DCalcium gluconate葡萄糖酸鈣
— Explanation · 中文詳解 —
高血鉀 6.2 mEq/L 已達需移除鉀離子的程度。Sodium polystyrene sulfonate 為離子交換樹脂，能透過腸胃道將鉀離子排出體外。D 雖能保護心肌，但不能降低血鉀；B 會導致血鉀升高；D 在嚴重腎衰竭效果有限。
Sodium polystyrene sulfonate is the anticipated medication as it acts as an ion-exchange resin to bind potassium in the gastrointestinal tract for excretion, directly lowering serum levels. Although calcium gluconate stabilizes the cardiac membrane, it does not reduce potassium concentration, and spironolactone is contraindicated as it retains potassium.
✦ 台美臨床差異
美台對於高血鉀處置流程相似，但台灣臨床常用 Patiromer 較少見。