# 一位服用鋰鹽的個案在數天嘔吐及腹瀉後來電。護理師應先採取哪項行動？ > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=522090&lang=zh-tw > language: zh-TW > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## 題目 一位服用鋰鹽的個案在數天嘔吐及腹瀉後來電。護理師應先採取哪項行動？ History Vitals Labs Orders Notes 雙極性疾患以鋰鹽治療；嘔吐及腹瀉已 3 天 (데이터 없음) 肌酸酐從 0.9 mg/dL 升至 1.9 mg/dL；鈉 130 mEq/L；鋰鹽濃度急件檢驗中 (데이터 없음) (데이터 없음) 1 按時服用鋰鹽並合併 ibuprofen，同時減少口服液體。 ✕ 2 暫停鋰鹽，並緊急評估毒性、腎功能及電解質異常。 ✕ 3 嘔吐停止後，將下一次鋰鹽劑量加倍。 ✕ 4 繼續服用鋰鹽，等待之後的常規濃度檢查。 ✕ ## 解析 體液及鈉流失、NSAID 使用、粗顫抖、步態不穩、意識混亂及腎功能受損，強烈暗示鋰鹽中毒，需要暫停用藥並緊急評估。 ## 深入解析 快速解答 因脫水加上神經學鋰鹽毒性而停藥。 為何正確 鋰鹽的治療範圍狹窄。脫水及 NSAIDs 會降低腎臟清除率，並增加血清鋰鹽濃度。 簡單比喻或心智圖像 將用藥安全視為呼吸道檢傷分類：找出威脅、中斷暴露、支持生理功能，並確認反應能持續。 記憶口訣 線索、風險、行動、反應、復發檢查。 NCLEX 決策原則 選擇能預防最立即用藥相關傷害，同時保留重新評估與升級處置的行動。 為何其他選項錯誤 將惡化視為正常、增加會交互作用的藥物，或延遲救援的選項，都會讓安全迴路無法閉合。參考資料 1DailyMed: Lithium Carbonate脫水、腎功能受損、鈉流失、NSAIDs 及神經學症狀相關的毒性 ## 臨床情境 用藥安全檢視 確認適應症、目前評估、呼吸及神經學狀態、交互作用、經授權的救援行動，以及可量測的追蹤。 ## 相同主題題目 - [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=zh-tw) - [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=zh-tw) - [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=zh-tw) - [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=zh-tw) - [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=zh-tw) - [A nurse is monitoring a client receiving a continuous IV heparin infusion for pulmonary em…](https://mymerci.kr/pages/nclex_q.php?qn_id=363988&lang=zh-tw) - [A nurse is preparing to initiate a weight-based continuous IV unfractionated heparin infus…](https://mymerci.kr/pages/nclex_q.php?qn_id=364107&lang=zh-tw) - [A nurse is providing discharge teaching to a 65-year-old client newly prescribed warfarin …](https://mymerci.kr/pages/nclex_q.php?qn_id=364872&lang=zh-tw) ## 以其他語言閱讀 - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=522090&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=522090&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=522090&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=522090&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=522090&lang=vi) --- More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw) _僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_