護理師監測剛服用第一劑 Ciprofloxacin 的病人。哪項發現是首要關注點？
A nurse is monitoring a client who just received their first dose of Ciprofloxacin. Which finding is a priority?
- ANausea and diarrhea噁心與腹瀉
- BHeadache and dizziness頭痛與頭暈
- CTendon pain or swelling✓ 正解肌腱疼痛或腫脹
- DSun sensitivity光敏感
Ciprofloxacin 屬於氟喹諾酮類（Fluoroquinolones）抗生素。這類藥物有一個非常特殊的「黑框警告（Black Box Warning）」：增加肌腱炎與肌腱斷裂（Tendon Rupture）的風險，尤其是阿基里斯腱（Achilles tendon）。這種風險在老年人、同時使用類固醇者或腎功能不全者中更高。雖然噁心、頭痛或光敏感也是常見副作用，但肌腱斷裂涉及嚴重的運動功能損傷且具有突發性，屬於「安全優先」的範疇。護理師必須指導病人在出現任何關節痛、腫脹或發炎徵兆時，應立即停止服藥、減少活動並聯繫醫療人員。
Ciprofloxacin is a fluoroquinolone antibiotic. This drug class carries a distinctive Black Box Warning: an increased risk of tendinitis and tendon rupture, especially of the Achilles tendon. The risk is higher in the elderly, in those concurrently using corticosteroids, and in patients with renal impairment. Although nausea, headache, and photosensitivity are also common side effects, tendon rupture causes severe functional impairment with sudden onset, falling under the 'safety first' category. The nurse must instruct the client to immediately stop the medication, reduce activity, and contact a provider at any sign of joint pain, swelling, or inflammation.
美國 FDA 對氟喹諾酮類藥物的限制越來越嚴格，僅建議在無其他選擇時用於簡單感染。台灣臨床則仍廣泛使用於泌尿道或呼吸道感染。護理師在準備 NCLEX 時，必須牢記「肌腱斷裂」這個黑框警告。