— 生理適應 · HARD · MCQ —
一位慢性腎臟病病人血鉀濃度為 6.5 mEq/L，護理師應預期醫師優先開立何種藥物？
A client with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L. Which medication should the nurse anticipate being prescribed first?
- ACalcium gluconate✓ 正解葡萄糖酸鈣
- BRegular insulin and dextrose常規胰島素和右旋糖
- CFurosemide呋塞米
- DSodium polystyrene sulfonate聚苯乙烯磺酸钠
— Explanation · 中文詳解 —
高血鉀緊急處理優先順序為保護心肌，防止心律不整。鈣離子能穩定細胞膜電位，雖無法降低鉀離子濃度，但為首要搶救心臟之措施。胰島素與葡萄糖為隨後加速鉀離子進入細胞的藥物，磺酸聚苯乙烯鈉為長期移除鉀之措施，利尿劑在嚴重腎衰竭效果有限。
Calcium gluconate is administered first to stabilize the cardiac membrane and prevent fatal arrhythmias caused by severe hyperkalemia. Other treatments like insulin, diuretics, or sodium polystyrene sulfonate work more slowly or are less effective in this acute context.
✦ 台美臨床差異
美台臨床皆視高血鉀為急症，護理師在給予鈣離子前需監測 ECG，且此藥屬高警訊藥物。