病人正在接受肝素（heparin）點滴注射，護理師發現 aPTT 為 110 秒。優先護理措施為何？
A client is receiving an intravenous infusion of heparin. The nurse notes the aPTT is 110 seconds. What is the priority nursing action?
- AContinue the infusion as ordered按照指示繼續點滴注射
- BAdminister protamine sulfate給予硫酸魚精蛋白
- CStop the infusion and notify the provider✓ 正解停止點滴並通知醫師
- DIncrease the infusion rate增加點滴速率
肝素（Heparin）治療需嚴密監測活化部分凝血活酶時間（aPTT）。治療範圍通常是對照值的 1.5 到 2.5 倍。當數值達到 110 秒時，意味著凝血功能受到嚴重抑制，病人處於極高的出血風險中。此時護理師應立即停止給藥（Stop the infusion）以減少體內藥物濃度，並通知醫師評估是否需要減量或給予拮抗劑。
Heparin therapy requires close monitoring of the activated partial thromboplastin time (aPTT). The therapeutic range is typically 1.5 to 2.5 times the control. An aPTT of 110 seconds indicates that coagulation is severely suppressed and the client is at very high risk of bleeding. The nurse should immediately stop the infusion to reduce the drug concentration in the body and notify the provider to determine whether a dose reduction or antidote is needed.
在美國臨床，護理師通常依據醫院制定的 Heparin Protocol（肝素滴定指引）執行，該指引會明確列出不同 aPTT 數值對應的滴注調整或停藥步驟。