護理師正為一位新處方服用碳酸鋰(lithium carbonate)治療雙極性疾患的病人提供出院指導。應包含哪些內容?(選所有適合的)
The nurse is providing discharge instructions for a client newly prescribed lithium carbonate for bipolar disorder. Which instructions should the nurse include? (Select all that apply.)
- AMaintain a consistent intake of dietary sodium✓ 正解維持穩定的飲食鈉攝取量
- BLimit fluid intake to less than 1,000 mL per day將每日水分攝取量限制在 1,000 mL 以下
- CReport excessive thirst and increased urination✓ 正解報告過度口渴及排尿增加的情況
- DAvoid activities that cause excessive sweating✓ 正解避免導致過度出汗的活動
- EStop taking the medication if common cold symptoms occur若出現普通感冒症狀請停止服藥
鋰鹽(Lithium)是一種與鈉鹽(Sodium)在腎臟中競爭排泄的藥物。核心概念在於維持體內電解質與水分的平衡,以防止鋰中毒。若鈉攝取量大幅下降或身體因流汗過多、脫水導致鈉流失,腎臟會保留鋰以補償鈉的不足,導致血鋰濃度升高。因此,病人必須維持穩定的鈉攝取量(A)並避免過度脫水(D)。口渴與尿量增加(C)可能是鋰中毒的早期徵兆或鋰引起尿崩症的表現,必須回報。限制水分(B)是極大錯誤,會增加中毒風險。感冒時應持續用藥(E),除非有嚴重嘔吐或腹瀉導致脫水,需由醫師調整。
Clients taking lithium must maintain a consistent dietary sodium intake and adequate fluid volume to prevent lithium toxicity. Excessive sweating or dehydration can lead to sodium loss, causing the kidneys to retain lithium and raise serum levels. Nurses should instruct clients to report excessive thirst and polyuria, as these may indicate early signs of toxicity or diabetes insipidus.
美國 NCLEX 非常強調 Lithium 與 Sodium 的負相關性。在台灣臨床衛教中,有時會過於簡化為「多喝水」,較少深入探討食鹽(鈉)穩定性的重要性,護理師需特別加強這方面的藥物動力學教育。