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藥理與非經腸給藥 · MEDIUM · MCQ

一位病人因 MRSA 感染正接受萬古黴素(Vancomycin)靜脈注射。輸注過程中,病人頸部與臉部出現劇烈潮紅。護理師應優先採取哪項行動?

A client is receiving vancomycin IV for an MRSA infection. During the infusion, the client develops intense flushing of the neck and face. Which action should the nurse take first?

  • ASlow the rate of the vancomycin infusion✓ 正解
    減慢萬古黴素輸注速率
  • BDiscontinue the infusion and notify the provider
    停止輸注並通知醫師
  • CAdminister intramuscular epinephrine immediately
    立即給予肌肉注射腎上腺素
  • DApply cool compresses to the affected areas
    在受影響區域應用冷敷
Explanation · 中文詳解

病人出現的是「紅人症候群」(Red Man Syndrome),這是由於萬古黴素輸注速度過快導致組胺釋放,並非真正的過敏性休克(Anaphylaxis)。典型的徵兆包括臉部、頸部和上半身潮紅、搔癢。處置方法是將輸注時間延長(至少 60-90 分鐘)。如果症狀嚴重才考慮停藥,一般只需減慢速度並觀察。

The client is experiencing Red Man Syndrome, which is caused by histamine release due to overly rapid vancomycin infusion and is not true anaphylaxis. Typical signs include flushing and itching of the face, neck, and upper body. The treatment is to extend the infusion time (to at least 60-90 minutes). The infusion is discontinued only if symptoms are severe; in most cases, slowing the infusion rate and observing the client is sufficient.

✦ 台美臨床差異

美國 NCLEX 考題常將紅人症候群與過敏區分;台灣臨床則習慣將所有過敏反應統稱,需加強鑑別診斷教學。

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