— 藥理與非經腸給藥 · HARD · MCQ —
一位有氣喘病史的病人獲開立普萘洛爾（Propranolol），護理師發現哪項評估結果應立即報告醫師？
A client with a history of asthma is prescribed propranolol. Which assessment finding should the nurse report to the provider immediately?
- ABlood pressure of 120/80 mmHg血壓 120/80 mmHg
- BWheezing and shortness of breath✓ 正解哮鳴音與呼吸困難
- CDizziness upon standing站立時頭暈
- DHeart rate of 65 bpm心率 65 bpm
— Explanation · 中文詳解 —
Propranolol 是一種非選擇性 beta 受體阻斷劑，會同時阻斷 beta-1（心臟）與 beta-2（支氣管平滑肌）受體。對氣喘病人使用會導致支氣管痙攣（bronchospasm），引發喘鳴與呼吸困難。即便在低劑量下也應極度謹慎，出現呼吸道症狀代表藥物已造成支氣管收縮，屬醫療緊急情況。
Propranolol is a non-selective beta blocker that blocks both beta-1 (cardiac) and beta-2 (bronchial smooth muscle) receptors. In clients with asthma, it can cause bronchospasm, leading to wheezing and shortness of breath. Extreme caution is required even at low doses, and the appearance of respiratory symptoms indicates that the medication has caused bronchoconstriction, which is a medical emergency.
✦ 台美臨床差異
台灣醫囑開立時通常會註記病人氣喘病史，護理師給藥前應再次查核，若發生 bronchospasm 需立即給予支氣管擴張劑。