# 一位服用氯噻酮 (chlorthalidone) 的客戶出現意識模糊、噁心，且鈉濃度為 119 mEq/L。護理師應採取何種措施？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522079&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位服用氯噻酮 (chlorthalidone) 的客戶出現意識模糊、噁心，且鈉濃度為 119 mEq/L。護理師應採取何種措施？

## 選項

1. 給予氯噻酮並額外補充自由水，並在下次常規訪視時重複檢查鈉濃度。
2. 繼續服用氯噻酮，因為意識模糊和噁心是預期的早期治療效果。
3. 增加氯噻酮劑量以加速鈉和水排泄，然後再重新評估。
4. 暫停氯噻酮，並取得緊急評估和針對電解質的治療醫囑。 **✔ 正確答案**

**正確答案: 4**

## 解析

嚴重的症狀性低血鈉症是類噻嗪利尿劑的嚴重併發症，需要暫停藥物並緊急評估。

## 深入解析

快速解答
升級處理有症狀的嚴重低血鈉症。

為什麼這是正確的
氯噻酮可能導致低血鈉症和其他電解質異常；鈉濃度為 119 mEq/L 伴隨意識模糊並非常規追蹤情況。

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
線索、行動、反應、重新評估。

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

為什麼其他選項是錯誤的
延遲升級、忽略禁忌症或未經授權改變治療的選項，並未關閉安全循環。References
1DailyMed: HEMICLOR (chlorthalidone)Hyponatremia and other electrolyte abnormalities, renal function, and monitoring

## 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、授權行動和可測量的後續追蹤。

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