— 藥理與非經腸給藥 · HARD · MCQ —
護理師照護一位開始使用鋰鹽（Lithium）治療的病人。下列哪項評估對護理師最重要？
A nurse is caring for a client starting Lithium therapy. Which clinical assessment is most important for the nurse to perform?
- AAssess for a metallic taste評估是否有金屬味
- BMonitor fluid intake and output✓ 正解監測出入水量
- CMonitor daily weight監測每日體重
- DCheck for signs of coarse tremors檢查是否有粗大震顫跡象
— Explanation · 中文詳解 —
鋰鹽（Lithium）治療指數狹窄，意味著治療濃度與中毒濃度非常接近。鋰鹽與鈉離子在腎臟代謝上有競爭性，若病人水分攝取不足、出汗過多或腹瀉（脫水），會導致鈉離子流失，腎臟進而過度保留鋰離子，引發鋰鹽中毒。因此，維持水分平衡與監測輸出入量（I/O）是預防鋰鹽中毒的最關鍵措施。護理師應教導病人每日攝取足夠水分，並定期回診監測血鋰濃度。
Lithium has a narrow therapeutic index, making toxicity a significant risk if fluid or sodium levels fluctuate. Because lithium is excreted by the kidneys and competes with sodium, maintaining adequate fluid intake and monitoring intake and output are critical to prevent dehydration-induced lithium retention and subsequent toxicity.