— 生理適應 · MEDIUM · MCQ —
一位急性胰臟炎病人正接受靜脈輸液且禁食（NPO）。下列哪項評估發現最令護理師擔心？
A client with acute pancreatitis is receiving IV fluids and is NPO. Which assessment finding is most concerning to the nurse?
- ASerum lipase level of 400 U/L血清脂解酶水平為 400 U/L
- BBlood glucose level of 160 mg/dL血糖水平為 160 mg/dL
- CHypoactive bowel sounds腸鳴音減弱
- DMuscle twitching and numbness around the mouth✓ 正解肌肉抽搐和嘴脣周圍麻木
— Explanation · 中文詳解 —
急性胰臟炎常因脂肪壞死導致鈣質沈積，引發低血鈣。口周麻木（Chvostek's sign 或 Trousseau's sign 的前兆）是低血鈣的特徵性表現，若不處理可能誘發抽搐或心律不整，是優先處理的危急徵象。
Perioral numbness and muscle twitching are early signs of hypocalcemia, a serious complication of acute pancreatitis caused by calcium binding to fatty acids during fat necrosis. While elevated lipase, mild hyperglycemia, and hypoactive bowel sounds are expected findings, hypocalcemia can lead to life-threatening arrhythmias or seizures and requires immediate intervention.
✦ 台美臨床差異
美國護理師常需負責評估並向醫師通報電解質異常；台灣多數情況下護理師發現後會先告知醫師，由醫師評估是否補充鈣離子。