— 生理適應 · MEDIUM · MCQ —
一位急性胰臟炎病人出現嚴重腹痛與噁心，護理師評估發現 Chvostek's 徵象陽性。此病人最可能出現哪種電解質異常？
A client with acute pancreatitis presents with severe abdominal pain and nausea. The nurse notes a positive Chvostek's sign. Which electrolyte imbalance is likely present?
- AHypomagnesemia低血鎂
- BHyponatremia低血鈉
- CHyperkalemia高血鉀
- DHypocalcemia✓ 正解低血鈣
— Explanation · 中文詳解 —
急性胰臟炎時，胰臟酵素活化造成腹膜內脂肪壞死（fat necrosis），釋出的游離脂肪酸與鈣離子結合形成皂化反應，導致血鈣下降。低血鈣會增加神經肌肉興奮性，臨床上以 Chvostek 徵象（輕敲顏面神經引起同側肌肉抽動）及 Trousseau 徵象呈現。護理師應監測血鈣值、密切觀察手足抽搐與喉痙攣，並準備靜脈輸注葡萄糖酸鈣矯正。
Therapeutic communication with a client expressing hopelessness involves using open-ended questions to encourage the exploration of feelings, such as asking the client to describe their current emotional state. This approach validates the client's experience, whereas false reassurance or changing the subject minimizes their distress.