# 服用鋰鹽的個案，哪一項敘述表示出院衛教是有效的？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375326&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

服用鋰鹽的個案，哪一項敘述表示出院衛教是有效的？

## 選項

1. 如果我忘記服藥，我會在下次預定時間服用兩倍劑量，以維持我的 lithium 濃度穩定。
2. 我每天最多只能喝幾口水，以免 lithium 被排出體外。
3. 我應維持鹽分攝取穩定；如果有嘔吐、腹瀉、發燒或大量出汗，應打電話給診所。 **✔ 正確答案**
4. 我可以安全地使用非處方 ibuprofen 來緩解疼痛，因為它不會影響我的 lithium 濃度。

**正確答案: 3**

## 解析

鋰鹽的衛教重點在於維持穩定的鈉與水分攝取、脫水時的毒性預防措施，以及除非經核准否則避免使用會產生交互作用的藥物。嘔吐、腹瀉、發燒、大量流汗、低鈉攝取、非類固醇抗發炎藥 (NSAIDs)、血管收縮素轉化酶抑制劑 (ACE inhibitors)、血管收縮素受體阻斷劑 (ARBs) 和噻嗪類利尿劑都可能增加鋰鹽的毒性風險。

## 深入解析

記憶提示 鋰跟著鹽與水走：穩定鈉 + 穩定水分 = 較安全濃度。伴隨體液流失的疾病是需要聯絡診所的事件。

## 臨床情境

情境 鋰的退院衛教。

## 重要概念

- **鈉攝取穩定性** — 低鈉攝取或鈉流失會增加腎臟對鋰的再吸收，可能升高血清鋰。
- **生病日衛教** — 嘔吐、腹瀉、發燒或大量出汗可能造成脫水與毒性；繼續服藥前應先聯絡。
- **漏服安全** — 不要把鋰加倍服用。遵循處方的漏服指示，或聯絡診所。

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