— 降低風險 · MEDIUM · MCQ —
護理師指導病人服用碳酸鋰（Lithium），下列哪項衛教對於預防中毒至關重要？
A nurse is teaching a client about lithium carbonate therapy. Which instruction is essential to prevent toxicity?
- AMaintain a consistent sodium intake✓ 正解維持穩定的鈉攝取量
- BTake the medication on an empty stomach空腹服用藥物
- CIncrease caffeine intake daily每日增加咖啡因攝取
- DAvoid all forms of physical exercise避免任何形式的體力活動
— Explanation · 中文詳解 —
碳酸鋰（Lithium）的治療指數極窄，其排泄與鈉離子密切相關。鋰離子與鈉離子在近端腎小管競爭再吸收。若鈉攝取量過低或流失過多，腎臟會轉而增加鋰的再吸收，導致血鋰濃度上升引發中毒。因此，護理衛教重點在於維持穩定的鹽分攝取與水分攝取，確保腎臟排泄功能穩定。臨床上若病人出現噁心、嘔吐、震顫、共濟失調等症狀，應高度懷疑鋰中毒。
Lithium and sodium compete for reabsorption in the renal tubules, so maintaining a consistent sodium intake is crucial to prevent lithium toxicity. Low sodium levels cause the kidneys to retain more lithium, leading to elevated serum levels and potential adverse effects. Clients should also maintain adequate fluid intake to ensure stable renal excretion of the medication.