# 一名27歲、因雙相情緒障礙服用鋰的個案，在家用驗孕呈陽性後打電話到診所。護理師最適當的回應是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375325&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名27歲、因雙相情緒障礙服用鋰的個案，在家用驗孕呈陽性後打電話到診所。護理師最適當的回應是什麼？

## 選項

1. 建議個案儘快聯絡處方者，以評估胎兒風險、復發風險與較安全的治療計畫。 **✔ 正確答案**
2. 指示個案立刻突然停用鋰，並立即丟棄藥物。
3. 告訴個案葉酸可以消除鋰相關的胎兒風險。
4. 鋰在懷孕期間完全安全，所以不需聯絡處方者，應繼續服用。

**正確答案: 1**

## 解析

懷孕期間，尤其早期懷孕暴露於鋰，與胎兒心臟風險相關；但突然停藥可能引發嚴重情緒復發。護理師應迅速轉介給處方者進行共同決策與用藥規劃，而不是單方面指示停藥或繼續。

## 深入解析

注意 情緒穩定劑與懷孕題目需要平衡風險思考：胎兒暴露風險與母體復發風險都很重要。不要建議在沒有處方者指導下突然自行停藥。

## 臨床情境

情境 鋰治療中 + 驗孕陽性。

## 重要概念

- **鋰與懷孕** — 第一孕期暴露與先天性心臟風險相關；需要個別化風險效益評估。
- **情緒復發風險** — 突然停用情緒穩定劑可能導致躁症、憂鬱、自殺風險或產前照護受損。
- **共同決策** — 處方者、精神科與產科團隊應權衡母體穩定、胎兒風險、替代方案與監測。

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