一位急性腎損傷（AKI）病人，血鉀值為 6.2 mEq/L。護理師應預期醫師會開立何種藥物來處理此電解質異常？
A client is diagnosed with acute kidney injury (AKI) and has a serum potassium level of 6.2 mEq/L. Which medication should the nurse anticipate the provider will order to address this electrolyte imbalance?
- ACalcium carbonate碳酸鈣
- BSpironolactone螺內酯
- CSodium polystyrene sulfonate✓ 正解聚苯乙烯磺酸鈉
- DFurosemide呋塞米
高血鉀是腎損傷的危險併發症，Sodium polystyrene sulfonate 可藉由陽離子交換機制，在腸道結合鉀離子並隨糞便排出。選項 D 雖有排鉀作用，但在急性且高數值下非首選；B 則會導致血鉀進一步升高；D 用於補鈣或磷結合，不處理高血鉀。
Sodium polystyrene sulfonate is indicated to treat hyperkalemia by binding potassium in the gastrointestinal tract for excretion via feces. While loop diuretics like furosemide can help excrete potassium, they are less effective in acute settings with significant renal impairment compared to cation-exchange resins. Spironolactone is contraindicated as it is potassium-sparing, and calcium carbonate does not lower serum potassium levels.
美國護理師常依據 Protocol 主動給予降鉀藥物，台灣臨床則更嚴格依賴醫師開立 Order 執行。