# 一名使用PPI 1年的個案Mg 1.2 mEq/L，醫囑magnesium sulfate 2 g IV。優先評估是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391827&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名使用PPI 1年的個案Mg 1.2 mEq/L，醫囑magnesium sulfate 2 g IV。優先評估是什麼？

## 選項

1. 肝功能
2. 深部肌腱反射、呼吸速率、血壓、尿量與ECG；輸注過快會造成低血壓和反射消失 **✔ 正確答案**
3. 視力
4. 血糖

**正確答案: 2**

## 解析

正確（2）：IV鎂補充需監測深部肌腱反射、呼吸速率、血壓、尿量≥30 mL/hr、ECG。快速輸注或過量會造成低血壓、反射消失、呼吸抑制；解毒藥是葡萄糖酸鈣。（1、3、4）不是Mg相關優先評估。

## 深入解析

記憶提示 Mg sulfate IV監測＝反射、呼吸、血壓、尿量，和產科子癇前症的Mg監測類似；非子癇補充要慢速。

## 臨床情境

情境 58歲女性使用PPI 1年，Mg 1.2 mEq/L，醫囑magnesium sulfate 2 g IV於1小時內給予。

## 重要概念

- **低鎂血症** — 原因包括PPI、利尿劑、酒精、腸胃流失；症狀有手足搐搦、顫抖、心律不整。
- **靜脈鎂補充流程** — 輕症可1-2 g IV於1小時給予；通常不超過1 g/hr；解毒用葡萄糖酸鈣。
- **Mg補充與產科流程** — 一般補充為1-2 g/hr；產科子癇前症常用4-6 g負荷後2 g/hr。

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