慢性腎病病人正在接受紅血球生成素（Epoetin Alfa）。若發現哪項檢驗值，護理師應暫緩給藥並通知醫師？
A client with chronic kidney disease is receiving Epoetin Alfa. The nurse should hold the dose and notify the provider if which lab value is noted?
- AHemoglobin 12 g/dL✓ 正解血紅素 12 g/dL
- BCreatinine 3.5 mg/dL肌酸酐 3.5 mg/dL
- CWhite blood cell count 6,000/mm³白血球計數 6,000/mm³
- DPotassium 4.8 mEq/L鉀離子 4.8 mEq/L
紅血球生成素（Epoetin Alfa）是一種重組人類紅血球生成素，用於治療慢性腎病（Chronic Kidney Disease, CKD）引起的貧血。它能刺激骨髓產生紅血球，從而提高血紅素（Hemoglobin, Hgb）水平。然而，過度升高血紅素水平會增加血栓栓塞事件（Thromboembolic Events）的風險，如中風、心肌梗塞和靜脈血栓。因此，護理師在給予 Epoetin Alfa 之前，必須監測病人的血紅素水平，並根據醫囑和臨床指引，在血紅素達到一定閾值時暫緩給藥，以確保病人安全。這項措施是預防嚴重併發症的關鍵。
Epoetin alfa is a recombinant human erythropoietin used to treat the anemia of chronic kidney disease (CKD). It stimulates the bone marrow to produce red blood cells and thereby raises the hemoglobin (Hgb) level. However, excessively high hemoglobin increases the risk of thromboembolic events such as stroke, myocardial infarction, and venous thrombosis. Before administering epoetin alfa, the nurse must therefore monitor the hemoglobin level and, in accordance with the prescription and clinical guidelines, withhold the dose once Hgb exceeds a certain threshold to ensure client safety. This is a critical measure for preventing serious complications.
紅血球生成素（Epoetin Alfa）在台灣和美國的臨床應用與血紅素（Hgb）目標值監測方面是高度一致的。兩地都將 Hgb 維持在 10-11.5 g/dL 左右作為目標，避免超過 12 g/dL，以降低血栓栓塞事件的風險。美國食品藥物管理局（FDA）和腎臟病學會（ASN）有明確的指導原則。台灣的健保給付和臨床指引也遵循類似的國際標準。因此，此題的臨床實踐在兩地並無顯著差異。