— 生理適應 · HARD · MCQ —
一位頭部外傷病人出現多尿、高血鈉與極低的尿比重。護理師懷疑發生什麼狀況？
A client with a head injury develops polyuria, hypernatremia, and a very low urine specific gravity. Which condition does the nurse suspect?
- ADiabetic Ketoacidosis糖尿病酮酸中毒 (Diabetic Ketoacidosis)
- BSyndrome of Inappropriate Antidiuretic Hormone (SIADH)抗利尿激素分泌不當症候群 (SIADH)
- CAcute Kidney Injury急性腎損傷 (Acute Kidney Injury)
- DDiabetes Insipidus✓ 正解尿崩症 (Diabetes Insipidus)
— Explanation · 中文詳解 —
尿崩症（Diabetes Insipidus, DI）是由於抗利尿激素（ADH）缺乏或對其反應不足，導致腎小管無法重吸收水分，產生大量稀釋尿液。頭部外傷若傷及下視丘或腦下垂體後葉，會阻斷 ADH 分泌。臨床表現為多尿（Polyuria）、尿比重極低（Dilute urine），因大量水分流失導致血液濃縮，進而引發高血鈉。
Diabetes insipidus is suspected due to the triad of polyuria, hypernatremia, and low urine specific gravity following head trauma, indicating a deficiency in antidiuretic hormone (ADH). This condition prevents water reabsorption in the kidneys, leading to excessive dilute urine output and subsequent serum sodium concentration.