— 生理適應 · HARD · MCQ —
護理師正在照護一位急性胰臟炎病人。哪項評估發現最能指示有嚴重併發症？
A nurse is caring for a client with acute pancreatitis. Which assessment finding is most indicative of a severe complication?
- AElevated serum amylase and lipase血清澱粉酶和脂肪酶升高
- BEpigastric pain radiating to the back上腹痛放射至背部
- CNausea and vomiting噁心和嘔吐
- DHypotension and tachycardia✓ 正解低血壓和心搏過速
— Explanation · 中文詳解 —
急性胰臟炎嚴重的併發症可能包括出血、壞死性胰臟炎、全身性發炎反應症候群（SIRS）、急性呼吸窘迫症候群（ARDS）或低血容量性休克。低血壓合併心搏過速是休克或體液嚴重不足的警訊，代表病情危急。腹痛、噁心嘔吐、酵素升高是胰臟炎的常見表現，但不一定代表嚴重併發症。
Hypotension and tachycardia are critical indicators of hypovolemic shock or systemic inflammatory response syndrome (SIRS), which are severe complications of acute pancreatitis. While elevated enzymes and pain are expected findings, signs of hemodynamic instability suggest a life-threatening deterioration requiring immediate intervention.
✦ 台美臨床差異
美國的急診與重症醫學對於急性胰臟炎的嚴重度評估（如 Ranson's criteria, APACHE II score）有標準化工具；台灣的臨床也廣泛應用這些工具，但實際執行可能因團隊經驗而異。