病人獲醫囑使用靜脈注射萬古黴素（Vancomycin）。護理師應監測哪項評估指標以預防藥物毒性？
A client is prescribed vancomycin IV. Which assessment finding is most important for the nurse to monitor to prevent drug-induced toxicity?
- APeripheral white blood cell count周邊白血球計數
- BBlood glucose levels血糖值
- CHeart rate and blood pressure心率和血壓
- DSerum creatinine and trough levels✓ 正解血清肌酸酐和谷濃度
萬古黴素（Vancomycin）具有腎毒性（Nephrotoxicity）與耳毒性（Ototoxicity）。血清肌酸酐（Creatinine）能反映腎絲球過濾功能，是監測腎毒性的關鍵指標。同時，為了確保藥物達到治療濃度且避免毒性反應，必須監測藥物谷濃度（Trough level），通常於下一次給藥前 30 分鐘抽血。護理師需密切觀察這些數值以調整劑量，確保病人安全。
Vancomycin has both nephrotoxic and ototoxic effects. Serum creatinine reflects glomerular filtration function and is a key indicator for monitoring nephrotoxicity. At the same time, to ensure the medication reaches therapeutic levels while avoiding toxic reactions, drug trough levels must be monitored, typically drawn 30 minutes before the next dose. The nurse must closely observe these values to adjust dosing and ensure patient safety.
美國醫院臨床藥師（Clinical Pharmacist）通常會積極參與萬古黴素的劑量調整（Dosing protocol），護理師需與藥師密切配合。