# 因status asthmaticus連續接受albuterol霧化後，病人現在HR 145、細顫、血清K+ 2.9 mEq/L。優先護理行動是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391771&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

因status asthmaticus連續接受albuterol霧化後，病人現在HR 145、細顫、血清K+ 2.9 mEq/L。優先護理行動是什麼？

## 選項

1. 改成口服albuterol錠以減少副作用
2. 通知醫師，預期IV補鉀，並持續心臟監測以偵測心律不整 **✔ 正確答案**
3. 再給albuterol以持續支氣管擴張
4. 停止所有氣喘藥直到鉀正常

**正確答案: 2**

## 解析

正解 (2): 高劑量beta-2 agonist會使鉀移入細胞，造成低血鉀並增加心律不整風險。需通知醫師、預期IV補鉀並持續ECG。心搏過速與顫抖是高劑量beta-2刺激的預期反應。(1) 更多albuterol會惡化低K。(3) 口服錠全身副作用更多且效益較慢。(4) 仍需控制氣喘，只是調整劑量並矯正電解質。

## 深入解析

Memory Tip Beta-2 agonist過量 = 心搏過速 + 顫抖 + 低K。Beta-2也可造成輕度高血糖。CPG 連續霧化治療時每2-4小時監測K+。

## 臨床情境

Scenario 32歲男性因status asthmaticus連續接受albuterol霧化3次。現在HR 145、細顫、血清K+ 2.9 mEq/L，持續心臟監測中。

## 重要概念

- **Beta-2 agonist低血鉀** — 強烈beta-2刺激使鉀移入細胞；高劑量albuterol常見。
- **Status asthmaticus** — 對初始治療無反應的嚴重氣喘惡化，需要積極治療。
- **補鉀** — 有症狀且K

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