— 生理適應 · MEDIUM · MCQ —
一名 45 歲病人血鉀濃度為 6.8 mEq/L 入院，護理師應監測何種心電圖改變？
A 45-year-old client with a potassium level of 6.8 mEq/L is admitted. Which ECG change should the nurse monitor for?
- ATall, peaked T waves✓ 正解高大且尖銳的T波
- BProlonged QT intervalQT間期延長
- CDepressed ST segmentST段壓低
- DU wavesU波
— Explanation · 中文詳解 —
高血鉀會影響心肌細胞的去極化與再極化過程。血鉀升至 6.0 mEq/L 以上時，典型的早期心電圖特徵為高尖 T 波，隨後可能出現 PR 間期延長、QRS 波變寬及正弦波。D、C 為低血鉀特徵，B 則多見於低血鈣，皆非高血鉀之典型表现。
Hyperkalemia significantly affects cardiac conduction, with tall, peaked T waves being the earliest and most characteristic electrocardiogram finding. Other changes like prolonged QT intervals, depressed ST segments, and U waves are associated with hypocalcemia or hypokalemia, respectively, making peaked T waves the priority assessment for a potassium level of 6.8 mEq/L.
✦ 台美臨床差異
美台對高血鉀處理原則一致，但美國護理師依據 Order 可較快啟動緊急除鉀流程（如 IV Insulin/D50W）。