— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備經由靜脈輸注 phenytoin，下列哪項行動是正確的？
A nurse is preparing to administer phenytoin via an intravenous line. Which nursing action is appropriate?
- AMonitor for hypertension during the infusion在輸注期間監測高血壓
- BFlush the IV line with normal saline before and after administration✓ 正解在給藥前後以生理食鹽水沖洗靜脈管路
- CAdminister at a rate of 100 mg/min以100 mg/min的速度給藥
- DMix with dextrose 5% in water混合於5%葡萄糖水中
— Explanation · 中文詳解 —
Phenytoin 與多數藥物（特別是 dextrose 溶液）混合會產生結晶沉澱，因此必須使用生理食鹽水作為輸注前後的導管沖洗，以維持管路通暢並避免與殘留藥物產生不相容反應。過快推注會引起低血壓與心律不整。
Phenytoin precipitates as crystals when mixed with most medications, especially dextrose-containing solutions; normal saline must therefore be used to flush the line before and after administration to maintain patency and prevent incompatibility with residual drugs. A push that is too rapid causes hypotension and dysrhythmias.
✦ 台美臨床差異
台灣臨床多採用專用接頭或單獨管路輸注，美國護理師對藥物相容性查詢系統的使用更為頻繁。