— 藥理與非經腸給藥 · HARD · SATA —
病人因嚴重感染需靜脈注射萬古黴素（vancomycin）。護理師應採取哪些措施以確保用藥安全？（選所有適合的）
A client is prescribed intravenous vancomycin for a severe infection. Which actions should the nurse take to ensure safe administration? (Select all that apply.)
- AMonitor the infusion site for redness and swelling✓ 正解監測輸注部位是否有紅腫
- BAdminister the dose over at least 60 minutes✓ 正解將劑量在至少 60 分鐘內輸注完畢
- CDraw trough levels before the next dose✓ 正解在下一次給藥前抽取谷濃度
- DIncrease the rate if the client reports itching若病人報告搔癢，則加快輸注速率
- EAssess blood pressure during the infusion✓ 正解在輸注期間評估血壓
— Explanation · 中文詳解 —
萬古黴素具腎毒性與耳毒性，且輸注過快會引發「紅人症候群（Red Man Syndrome）」，故務必緩慢給藥。監測波谷濃度（trough level）是臨床藥學重點。紅人症狀包含低血壓與皮膚潮紅，故須監測血壓。搔癢為紅人症表現，調快流速只會使情況惡化。
Vancomycin is nephrotoxic and ototoxic, and rapid infusion can cause 'Red Man Syndrome,' so administration must be slow. Monitoring trough levels is a clinical pharmacology priority. Red Man Syndrome includes hypotension and skin flushing, so blood pressure must be monitored. Pruritus is a manifestation of Red Man Syndrome; increasing the infusion rate would only worsen the condition.
✦ 台美臨床差異
美台臨床皆嚴格要求監測波谷濃度，台灣護理師執行時更常需配合藥師確認劑量與濃度安全性。