— 生理適應 · MEDIUM · MCQ —
一位急性胰臟炎病患正在進行靜脈輸液並禁食。下列哪項評估發現是護理師需優先回報給醫師的重點？
A client with acute pancreatitis is receiving IV fluids and is NPO. Which assessment finding is the highest priority for the nurse to report to the provider?
- APain rating 6/10疼痛評分 6/10
- BBlood glucose 150 mg/dL血糖 150 mg/dL
- CHyperactive bowel sounds腸鳴音亢進
- DSerum calcium level 7.2 mg/dL✓ 正解血清鈣濃度 7.2 mg/dL
— Explanation · 中文詳解 —
低血鈣是急性胰臟炎的嚴重併發症，可能引發手足抽搐、喉頭痙攣或心律不整，威脅生命安全。其機轉為胰臟壞死釋放脂肪酸，與鈣離子結合形成皂化反應，導致血鈣降低。相比於腹痛（常見症狀）、血糖輕微偏高（壓力反應）或腸鳴音改變，低血鈣具有更高的急性危險性。
Hypocalcemia is a serious complication of acute pancreatitis caused by saponification, where fatty acids bind with calcium. This finding takes priority because severe hypocalcemia can lead to life-threatening tetany and cardiac arrhythmias, unlike pain or mild hyperglycemia.
✦ 台美臨床差異
美國醫護對於急性胰臟炎低血鈣的偵測極為敏銳，常主動補鈣；台灣臨床則常由醫師根據化驗結果開立醫囑。