— 生理適應 · MEDIUM · MCQ —
病人血鉀濃度為 6.8 mEq/L 入院。護理師應優先監測哪項心電圖變化？
A client is admitted with a potassium level of 6.8 mEq/L. Which ECG change should the nurse prioritize to identify?
- AST segment depressionST 段下壓
- BTall, peaked T waves✓ 正解高大尖銳的 T 波
- CFlattened T wavesT 波平坦
- DU wavesU 波
— Explanation · 中文詳解 —
高血鉀會影響心肌電生理，導致再極化過程改變，最先出現的特徵性心電圖變化即為高尖 T 波。若未及時處理，可能進展為 QRS 波變寬、P 波消失，最終導致致命性心律失常如心室顫動。其餘選項皆為低血鉀之常見表現。
Hyperkalemia affects myocardial electrophysiology, causing changes in repolarization that manifest earliest as tall, peaked T waves on the ECG. If left untreated, this can progress to widened QRS complexes, absent P waves, and potentially fatal arrhythmias like ventricular fibrillation. The other options listed, such as ST depression, flattened T waves, and U waves, are characteristic findings of hypokalemia.
✦ 台美臨床差異
美國護理師針對高血鉀可依危急值立即採取行動並準備藥物（如鈣劑）；台灣需先通報醫師後才能進行特定處置。