一名病人入院時檢測鉀離子為 6.2 mEq/L。護理師應優先監測心電圖上的哪種表現？
A client is admitted with a potassium level of 6.2 mEq/L. Which rhythm finding on the ECG should the nurse prioritize?
- AST-segment depressionST 段低下
- BFlattened P wavesP 波平坦
- CU wavesU 波
- DTall, peaked T waves✓ 正解高尖 T 波
高血鉀症（Hyperkalemia）會導致心肌電生理不穩定。臨床最危險的早期徵象是尖峰 T 波（Tall, peaked T waves），若不處理，接下來會出現 PR 間期延長、QRS 波變寬，甚至演變成心室顫動或心搏停止。A、B、C 選項多與低血鉀相關，非此電解質異常之典型特徵。
Hyperkalemia significantly affects cardiac conduction, with tall, peaked T waves being the earliest and most characteristic electrocardiogram finding. Recognizing this change is critical because untreated hyperkalemia can progress to widened QRS complexes, ventricular fibrillation, or asystole. Other options like ST depression or U waves are typically associated with hypokalemia or ischemia rather than elevated potassium levels.
美台臨床對於高血鉀處置皆依據 ACLS 流程，但在美國，護理師可依據校準過的實驗室報告立即啟動給藥流程，台灣則多需醫師確認後給藥。