# 護理師正在為一位新開立長期鋰鹽治療的個案檢視基礎實驗室監測。在治療前和治療期間，哪一組檢驗最為重要？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375324&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

護理師正在為一位新開立長期鋰鹽治療的個案檢視基礎實驗室監測。在治療前和治療期間，哪一組檢驗最為重要？

## 選項

1. 只需肝酵素，因為鋰主要由肝臟代謝。
2. 肌酸酐/BUN、電解質、TSH、適用時的懷孕狀態，以及血清鋰濃度。 **✔ 正確答案**
3. 每次服藥後30分鐘的peak鋰濃度，以及每日血小板計數。
4. 每週troponin與BNP，因為鋰常造成心肌梗塞。

**正確答案: 2**

## 解析

鋰鹽不經肝臟代謝；主要由腎臟清除，且可能影響甲狀腺功能。基礎及持續監測應包括腎功能、電解質/鈉、甲狀腺功能、懷孕狀態（若適用），以及排定的血清鋰鹽濃度。

## 深入解析

臨床實務指引 慢性鋰治療前，應檢查腎功能、鈉/電解質、甲狀腺狀態、相關時的懷孕狀態，並建立12小時trough濃度監測計畫。

## 臨床情境

情境 新開立長期鋰處方；需要基礎安全檢查。

## 重要概念

- **腎功能** — GFR下降會降低鋰清除率並提高中毒風險；應監測肌酸酐/BUN與水分狀態。
- **甲狀腺功能** — 鋰可能造成甲狀腺功能低下與甲狀腺腫；監測TSH及疲倦、體重增加、怕冷等症狀。
- **懷孕篩檢** — 鋰有胎兒風險，尤其與第一孕期心臟畸形相關；需討論風險與替代方案。

## 相同主題題目

- [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=zh-tw)
- [A 68-year-old client with COPD is admitted with shortness of breath and SpO2 86% on room a…](https://mymerci.kr/pages/nclex_q.php?qn_id=362940&lang=zh-tw)
- [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=zh-tw)
- [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=zh-tw)
- [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=zh-tw)
- [A 76-year-old female with chronic heart failure and atrial fibrillation receives digoxin 0…](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=zh-tw)
- [A 70-year-old client on long-term digoxin therapy reports new yellow-green halos around li…](https://mymerci.kr/pages/nclex_q.php?qn_id=374884&lang=zh-tw)
- [A 58-year-old client with type 2 diabetes mellitus and migraine prophylaxis is taking prop…](https://mymerci.kr/pages/nclex_q.php?qn_id=374893&lang=zh-tw)

## 以其他語言閱讀

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=375324&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=375324&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=375324&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=375324&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=375324&lang=vi)

---

More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw)

_僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_