— 生理適應 · HARD · MCQ —
一位病人因低血鉀入院。哪項檢驗結果需要立即通知醫療團隊？
A client is admitted with hypokalemia. Which laboratory result requires immediate notification of the healthcare provider?
- ACreatinine 1.2 mg/dL肌酸酐 1.2 mg/dL
- BDigoxin level 2.5 ng/mL✓ 正解地高辛濃度 2.5 ng/mL
- CMagnesium 1.2 mEq/L鎂 1.2 mEq/L
- DPotassium 2.8 mEq/L鉀 2.8 mEq/L
— Explanation · 中文詳解 —
低血鉀時，毛地黃（Digoxin）的藥物毒性顯著增加。當 Digoxin 血中濃度超過正常範圍（通常為 0.5-2.0 ng/mL），且病人合併低血鉀時，發生致命性心律不整的風險極高。雖然鉀離子 2.8（選項 D）很低，但合併 Digoxin 毒性時，後者的致命性更為緊急且複雜。
A digoxin level of 2.5 ng/mL in a client with hypokalemia requires immediate notification because low potassium levels significantly increase the risk of digoxin toxicity. This combination is life-threatening due to the high probability of developing fatal cardiac arrhythmias, making it more urgent than isolated electrolyte abnormalities.
✦ 台美臨床差異
美台臨床對於 Digoxin 監測標準一致，但美國醫院常有自動化的危險值警報系統協助護理師判斷。