— 藥理與非經腸給藥 · HARD · SATA —
對於接受靜脈輸注 Vancomycin 的病患，下列哪些護理措施是正確的？（選所有適合的）
Which of the following interventions are appropriate for a client receiving intravenous vancomycin? (Select all that apply.)
- AAdminister the dose over at least 60 minutes✓ 正解給藥時間至少應達 60 分鐘
- BAssess for red man syndrome during infusion✓ 正解輸注期間評估是否有紅人症候群
- CMonitor the trough level before the next dose✓ 正解在下一次給藥前監測血中濃度（trough level）
- DIncrease the infusion rate if the patient is stable若病人狀況穩定則加快輸注速率
- EAssess for signs of nephrotoxicity✓ 正解評估是否有腎毒性跡象
— Explanation · 中文詳解 —
Vancomycin 輸注速度過快會引發類紅人症候群（Red man syndrome），故需緩慢輸注（至少 60 分鐘）。該藥具有腎毒性與耳毒性，必須監測藥物血中谷濃度（Trough level）以調整劑量，並觀察尿量與腎功能指標，切勿擅自加快輸注速率。
Infusing vancomycin too rapidly can precipitate red man syndrome, so the dose must be administered slowly (over at least 60 minutes). Because the drug is both nephrotoxic and ototoxic, serum trough levels must be monitored to guide dosing, and urine output and renal function indicators must be observed. The infusion rate must never be increased independently.
✦ 台美臨床差異
兩地均高度依賴藥學部與實驗室監測血中谷濃度，但臨床護理師對輸注速度的執行準則在台灣與美國教學醫院皆嚴格一致。