— 生理適應 · HARD · MCQ —
護理師照護一位抗利尿激素分泌不當症候群 (SIADH) 的病人。哪項評估發現最可能？
A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which assessment finding is most likely?
- APolyuria and dilute urine多尿及稀釋尿液
- BHypernatremia and increased urine output高血鈉及尿量增加
- CHypervolemia and decreased urine specific gravity體液過多及尿液比重降低
- DHyponatremia and concentrated urine✓ 正解低血鈉及濃縮尿液
— Explanation · 中文詳解 —
SIADH 導致抗利尿激素 (ADH) 過度分泌，使得腎臟重吸收過多水分，造成體液滯留（Hypervolemia）和稀釋性低血鈉（Hyponatremia）。由於水分重吸收增加，尿液會變得濃縮，尿量減少，尿比重升高。
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) causes excessive water retention, leading to hyponatremia and concentrated urine with increased specific gravity. This results from the kidneys reabsorbing too much water due to elevated ADH levels, distinguishing it from conditions like diabetes insipidus.
✦ 台美臨床差異
美國內分泌學會對 SIADH 有詳細的診斷和治療指引；台灣醫師診斷 SIADH 後，護理師執行限水和監測電解質，但對疾病機轉的深入衛教可能因病人狀況而異。