# 一名雙相情緒障礙個案已服用碳酸鋰2週。護理師查看最後一次服藥後12小時抽血的鋰 trough 濃度為0.8 mEq/L。最適當的處置是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375322&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名雙相情緒障礙個案已服用碳酸鋰2週。護理師查看最後一次服藥後12小時抽血的鋰 trough 濃度為0.8 mEq/L。最適當的處置是什麼？

## 選項

1. 因濃度已達中毒範圍，暫停鋰並準備血液透析。
2. 給予聚苯乙烯磺酸鈉以降低鋰濃度。
3. 因急性躁症治療濃度不足，額外給予一劑。
4. 繼續依處方劑量服用，並強化說明此數值在一般治療範圍內。 **✔ 正確答案**

**正確答案: 4**

## 解析

12小時 trough 鋰濃度 0.6-1.2 mEq/L 對維持治療通常屬於治療範圍。若有脫水或腎功能受損，濃度接近或高於 1.5 mEq/L 時中毒風險會上升。護理師應維持目前計畫並強化定期監測，而不是停藥或加量。

## 深入解析

記憶提示 鋰是治療指數狹窄的藥物：確認12小時 trough，監測腎臟/甲狀腺功能，並教導充足水分與穩定鈉攝取。

## 臨床情境

情境 雙相情緒障礙，鋰治療2週，12小時 trough 0.8 mEq/L。

## 重要概念

- **鋰治療範圍** — 維持治療目標通常為12小時trough 0.6-1.2 mEq/L；急性躁症可依機構規範使用較高目標。
- **12小時trough濃度** — 約在最後一次服用後12小時抽鋰濃度，結果較能比較且具臨床解讀價值。
- **狹窄治療指數** — 腎清除率、鈉、水分狀態或交互作用藥物的微小變化，都可能使鋰濃度推向中毒範圍。

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