一名急性胰臟炎病人表現出劇烈腹痛。護理師應優先監測哪項檢驗數據以預防併發症?
A client with acute pancreatitis presents with severe abdominal pain. Which laboratory finding should the nurse prioritize to monitor for complications?
- ASerum glucose血清葡萄糖
- BSerum white blood cell count血清白血球計數
- CSerum amylase血清澱粉酶
- DSerum calcium✓ 正解血清鈣
急性胰臟炎(Acute Pancreatitis)是一種嚴重的胰臟發炎,可能導致全身性發炎反應,並引發多種併發症。劇烈腹痛是其典型症狀,但護理師更需關注可能危及生命的併發症。 在急性胰臟炎的病理生理過程中,脂肪組織的壞死(Fat Necrosis)是一個常見的併發症。壞死的脂肪組織會與體內的鈣離子結合,形成皂化物(Saponification),導致血液中的游離鈣離子濃度下降,引發低血鈣(Hypocalcemia)。嚴重低血鈣不僅會引起肌肉抽搐(Tetany)、手足搐搦(Trousseau's sign, Chvostek's sign),甚至可能干擾心臟傳導,引發心律不整。 因此,監測血鈣(Serum calcium)的變化是預防和管理急性胰臟炎併發症的優先項目。選項 D 是正確答案。 選項 C(血清澱粉酶)和 A(血清葡萄糖)雖然與胰臟功能相關,但血清澱粉酶升高是診斷依據,數值變化與病情嚴重度不一定完全相關;血糖升高則常見於胰臟炎,但低血鈣的影響更為直接且危急。選項 B(白血球計數)通常會升高,反映發炎,但不如血鈣變化對預測嚴重併發症的指示性強。
For a client with acute pancreatitis, the nurse should prioritize monitoring serum calcium levels because fat necrosis can lead to saponification and severe hypocalcemia. This complication is life-threatening as it can cause tetany, cardiac arrhythmias, and other serious issues. While amylase levels aid in diagnosis and glucose may fluctuate, calcium monitoring is critical for detecting immediate, severe metabolic complications.