# 一位患有慢性腎臟病 (CKD) 和第 2 型糖尿病的個案正在服用 finerenone。護理師應首先採取哪項行動？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522072&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位患有慢性腎臟病 (CKD) 和第 2 型糖尿病的個案正在服用 finerenone。護理師應首先採取哪項行動？

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患有慢性腎臟病 (CKD) 和第 2 型糖尿病，並伴有持續性蛋白尿

(데이터 없음)

鉀 5.8 mEq/L；eGFR 32 mL/min/1.73 m2

(데이터 없음)

(데이터 없음)

1

給予 finerenone 並在 6 個月後重複檢測鉀。

✕

2

暫停劑量並聯繫處方醫師，告知鉀為 5.8 mEq/L 以及新的 clarithromycin 處方。

✕

3

在給藥前鼓勵補充鉀。

✕

4

將 finerenone 劑量加倍，因為蛋白尿持續存在。

✕

## 解析

高血鉀和強效 CYP3A4 抑制劑會立即引起 finerenone 的安全疑慮，因此在給藥前需要澄清劑量和交互作用。

## 深入解析

快速解答
因高血鉀加上強效交互作用而停止。

為何這是正確的
Finerenone 可能引起高血鉀，且與強效 CYP3A4 抑制劑併用為禁忌；鉀和腎功能指導中斷和重新開始治療。

簡單類比或心像
將藥物安全想像成一個控制面板：識別危險信號，改變正確的控制，並驗證反應。

記憶點
提示、行動、反應、再評估。

NCLEX 決策規則
選擇能預防最即時藥物相關危害的行動，同時保留持續的適應症。

為何其他選項是錯誤的
延遲升級、忽略禁忌症或未經授權改變治療的選項，並未完成安全循環。References
1DailyMed: KERENDIA (finerenone)Potassium and eGFR assessment, hyperkalemia monitoring, dose interruption, and interaction safety

## 臨床情境

藥物安全審查
驗證適應症、當前評估、實驗室趨勢、時機、交互作用、授權行動和可衡量的追蹤。

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