— 生理適應 · HARD · MCQ —
一位慢性腎臟病 (CKD) 病人主訴肌肉無力與心悸，護理師預期他體內哪種電解質失衡？
A client with chronic kidney disease (CKD) reports muscle weakness and palpitations. The nurse expects an imbalance in which electrolyte?
- ACalcium鈣
- BMagnesium鎂
- CPotassium✓ 正解鉀
- DSodium鈉
— Explanation · 中文詳解 —
慢性腎臟病導致腎臟排鉀功能喪失，容易引起高血鉀。高血鉀會影響細胞電位傳導，導致肌肉無力、麻痺及心律不整（心悸）。心電圖常呈現高 T 波或 QRS 波變寬。鈣與鈉的變化雖常見，但對肌肉與心臟節律的最直接威脅源自鉀離子。
Chronic kidney disease impairs potassium excretion, leading to hyperkalemia, which can cause life-threatening cardiac arrhythmias and muscle weakness. Electrolyte imbalances in CKD require close monitoring because elevated potassium directly affects neuromuscular and cardiac function.
✦ 台美臨床差異
台美護理實務皆視高血鉀為急症，需優先聯繫醫師並執行心電圖監測與給予陽離子交換樹脂或胰島素療法。