# 一位接受乳果糖治療肝門體循環腦病變的病人。請審查趨勢並選擇最佳的解釋和計畫。 > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=522580&lang=zh-tw > language: zh-TW > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## 題目 一位接受乳果糖治療肝門體循環腦病變的病人。請審查趨勢並選擇最佳的解釋和計畫。 | Time | Data | | --- | --- | | Before therapy adjustment | 意識混亂；無排便；鈉 138 mEq/L；鉀 4.0 mEq/L | | Desired response | 警覺；24 小時內 3 次軟便；維持口服攝取 | | Current reassessment | 24 小時內 8 次水樣便；血壓 88/52 mm Hg；鈉 150 mEq/L；鉀 3.0 mEq/L | Q1. 目前的趨勢應如何解釋？ 預期的維持反應 乳果糖作用過度，導致體液和電解質流失 預期肝病永久治癒 Q2. 哪項計畫是適當的？ 暫停並釐清劑量，評估灌注，並補充醫囑的體液和電解質 增加乳果糖劑量直到所有糞便都呈液狀 忽略這些發現，因為精神狀態已改善 ## 解析 預期反應是認知改善，每天排便 2 或 3 次軟便。若進展為頻繁水樣便、低血壓、高血鈉和低血鉀，則表示過度通便以及體液和電解質流失。 ## 深入解析 快速答案 平衡腦病變的改善與過度導瀉。 為什麼這是正確的 乳果糖的劑量是根據排便反應來調整的。腹瀉次數增加不一定更好，反而可能導致嚴重的脫水和電解質併發症。 簡單類比或心像 使用閉環式藥物安全流程：識別暴露、連結新發現、中斷進一步傷害、支持生理功能，並隨時間驗證反應。 記憶點 暴露、交互作用、毒性模式、立即行動、連續再評估。 NCLEX 決策規則 選擇能降低最直接藥物相關風險，同時保留監測和升級的行動。 為什麼其他選項是錯誤的 繼續暴露、僅治療單一症狀或延遲再評估的選項會使毒性過程持續活躍。References 1DailyMed: Lactulose Solution劑量調整至每天 2 或 3 次軟便，並避免過度腹瀉和電解質流失 ## 臨床情境 藥物安全審查 驗證適應症、途徑、交互作用藥物、目前的呼吸道和胃腸道發現、授權行動以及可測量的後續追蹤。 ## 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=522580&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=522580&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=522580&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=522580&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=522580&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。_