# 一名患有原發性腎上腺功能不全的病人出現嘔吐、低血壓和意識模糊。哪項行動是優先事項？ > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=522755&lang=zh-tw > language: zh-TW > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## 題目 一名患有原發性腎上腺功能不全的病人出現嘔吐、低血壓和意識模糊。哪項行動是優先事項？ History Vitals Labs Orders Notes 原發性腎上腺功能不全；腸胃炎期間無法保留口服氫化可體松 (hydrocortisone) (데이터 없음) (데이터 없음) 可使用緊急糖皮質素、等張液體、葡萄糖支持和監測方案 (데이터 없음) 1 在治療前等待促腎上腺皮質素刺激試驗結果。 ✕ 2 立即給予經授權的腸道外氫化可體松 (hydrocortisone) 並開始等張液體復甦。 ✕ 3 嘔吐停止後給予常規口服氫化可體松 (hydrocortisone) 劑量。 ✕ 4 限制鈉和液體，直到鉀離子結果正常化。 ✕ ## 解析 疑似腎上腺危象需要立即給予腸道外氫化可體松 (hydrocortisone) 和液體復甦；治療不應等待確診檢測。若存在低血糖，則應予以糾正。 ## 深入解析 快速解答 將休克加上無法保留口服類固醇視為腎上腺危象進行治療。 為何這是正確的 皮質醇缺乏會損害血管張力和壓力反應。嘔吐會阻礙可靠的口服替代，而血容量不足、低鈉血症、高鉀血症或低血糖會迅速惡化。 簡單類比或心像 建立藥物安全鏈：識別線索群集，將其與藥物機制連結，停止可預防的暴露，穩定病人，並透過可測量的發現驗證反應。 記憶點 線索群集、藥物機制、保護性行動和可測量的重新評估。 NCLEX 決策規則 選擇能預防最即時藥物相關危害的行動，同時保留對潛在病情的治療。 為何其他選項是錯誤的 依賴單一令人安心的數值、繼續可疑暴露、繞過監測或延遲升級的選項，都會使藥物危害持續存在。References 1Endocrine Society Guideline: Primary Adrenal InsufficiencyImmediate parenteral hydrocortisone and fluid resuscitation for suspected adrenal crisis before confirmatory results ## 臨床情境 藥物安全審查 驗證適應症、當前評估、實驗室趨勢、時間、途徑、交互作用、經授權的行動和可測量的後續追蹤。 ## 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=522755&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=522755&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=522755&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=522755&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=522755&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。_