— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師指導使用鋰鹽（Lithium）的病人。關於飲食，最重要的指導原則為何？
A nurse is teaching a client on lithium therapy. What is the most important instruction regarding diet?
- AAvoid all salt in the diet避免飲食中攝取所有鹽分
- BAvoid all dairy products避免所有乳製品
- CMaintain a consistent sodium intake✓ 正解維持穩定的鈉攝取量
- DIncrease carbohydrate intake增加碳水化合物攝取量
— Explanation · 中文詳解 —
鋰鹽（Lithium）的治療指數狹窄，其代謝與鈉離子高度相關。腎臟對鈉與鋰的再吸收具有競爭性，若鈉攝取量過低，腎臟會增加對鋰的再吸收，導致鋰中毒；若鈉攝取量過高，鋰的排泄則會增加，導致治療濃度不足。因此，維持穩定且充足的鈉攝取是關鍵。病人在服藥期間需定期監測血鋰濃度，並注意鋰中毒徵兆（如震顫、共濟失調、混亂）。
Sodium intake directly affects lithium excretion because the kidneys reabsorb lithium when sodium levels are low, increasing the risk of toxicity. Conversely, high sodium intake can increase lithium excretion, leading to subtherapeutic levels. Therefore, maintaining a consistent daily sodium intake is crucial for stabilizing lithium blood levels.