一位病人預計進行含顯影劑的電腦斷層掃描（CT Scan）。護理師必須確保哪種藥物在檢查後暫緩服用 48 小時？
A client is scheduled for a CT scan with contrast. Which medication must the nurse ensure is held for 48 hours after the procedure?
- AMetformin✓ 正解Metformin（二甲雙胍）
- BAtorvastatinAtorvastatin（阿托伐他汀）
- CFurosemideFurosemide（呋塞米）
- DAspirinAspirin（阿斯匹靈）
Metformin（雙胍類降血糖藥）與含碘顯影劑（Iodinated Contrast）具有嚴重的交互作用。顯影劑具有潛在的腎毒性，若導致急性腎功能受損，Metformin 將無法正常排出而蓄積在體內，進而引發致命的「乳酸中毒（Lactic Acidosis）」。因此，標準的臨床指引要求在進行含顯影劑檢查當天應停用 Metformin，且在檢查後必須暫停 48 小時，直到確認腎功能恢復正常（通常監測肌酸酐）後方可重新服藥。選項 B、C、D 與顯影劑無此特定致命性交互作用。護理安全首重識別這類具有「災難性後果」的藥物風險。
Metformin (a biguanide antihyperglycemic) has a serious interaction with iodinated contrast media. Contrast agents have potential nephrotoxicity; if acute renal impairment occurs, metformin cannot be excreted normally and accumulates in the body, precipitating fatal lactic acidosis. Therefore, standard clinical guidelines require metformin to be held on the day of contrast-enhanced imaging and for 48 hours afterward, until renal function is confirmed to have returned to baseline (usually monitored by creatinine) before resuming the medication. Options B, C, and D do not have such specific, life-threatening interactions with contrast media. Nursing safety emphasizes recognizing drug risks with 'catastrophic consequences.'
美國放射學會（ACR）與台灣各大醫院的放射科指引都強調 Metformin 的停藥規定。不同之處在於美國護理師常需獨立審視病人的用藥清單（Medication Reconciliation）並發出警告；台灣則多由放射科或開單醫師執行初步篩選。