護理師監測 24 小時前發生心肌梗塞的病人。在此期間，病人發生哪種併發症的風險最高？
The nurse is monitoring a client who had a myocardial infarction 24 hours ago. Which complication is the client at highest risk for during this timeframe?
- AHeart failure心臟衰竭
- BPulmonary embolism肺栓塞
- CVentricular dysrhythmias✓ 正解心室性心律不整
- DPericarditis心包膜炎
心肌梗塞（MI）後的最初 24 小時是病人最脆弱的時期。受損的心肌細胞會釋放不穩定的電訊號，導致心律不整（Dysrhythmias）。心室性心律不整（如心室頻脈 VT 或心室顫動 VF）是此階段最常見的致死原因。臨床思路上，護理師的優先行動是持續的心電圖監測（Cardiac Monitoring）。雖然心衰竭也是常見併發症，但其發生通常較緩慢；而心律不整則是突發且致命的（Priority: Circulation/Electrical stability）。護理師應隨時準備好去顫器（Defibrillator）與急救藥物（如 Lidocaine 或 Amiodarone）。
The first 24 hours after a myocardial infarction (MI) is the most vulnerable period for the client. Damaged myocardial cells release unstable electrical signals, causing dysrhythmias. Ventricular dysrhythmias (such as ventricular tachycardia or ventricular fibrillation) are the most common cause of death during this period. Clinically, the nurse's priority action is continuous cardiac monitoring. Although heart failure is also a common complication, it usually develops more slowly; dysrhythmias, by contrast, are sudden and lethal (priority: circulation/electrical stability). The nurse should keep a defibrillator and emergency medications (such as lidocaine or amiodarone) ready at all times.
臨床監測重點相同。但在美國 NCLEX 中，常會考到 MI 後的藥物給予順序，例如 MONA (Morphine, Oxygen, Nitroglycerin, Aspirin)，雖然現在臨床指引已有所調整，但心律不整的優先性在考試中始終不變。