— 生理適應 · MEDIUM · MCQ —
慢性腎臟病病人出現嚴重疲倦與頭暈，血色素 7.2 g/dL。護理師應預期何種醫囑？
A client with chronic kidney disease (CKD) reports severe fatigue and dizziness. Laboratory results reveal hemoglobin 7.2 g/dL. What should the nurse anticipate?
- AInitiate IV fluids at 150 mL/hr開始以 150 mL/hr 速度靜脈輸液
- BImmediate blood transfusion立即輸血
- CAdministration of epoetin alfa✓ 正解給予益比奧（epoetin alfa）
- DIncrease dietary protein intake增加飲食蛋白質攝取量
— Explanation · 中文詳解 —
慢性腎臟病導致紅血球生成素分泌不足，進而引發貧血。當血色素低落導致疲倦，臨床上首選使用紅血球生成素（Epoetin alfa）來刺激骨髓造血。輸血風險較高，通常用於急性失血或極度症狀；增加蛋白質會加重腎臟負擔；IV 輸液則可能導致液體過負荷。
The nurse should anticipate the administration of epoetin alfa, as chronic kidney disease often leads to decreased erythropoietin production and subsequent anemia. Blood transfusions are typically reserved for acute, life-threatening situations, while fluid overload and excessive protein intake pose additional risks in clients with compromised renal function.
✦ 台美臨床差異
美台對 CKD 貧血治療原則一致，皆傾向使用藥物刺激而非依賴輸血，以降低抗體產生與鐵過載。