— 藥理與非經腸給藥 · HARD · MCQ —
一位患有慢性腎臟病的病人獲處方使用紅血球生成素（Epoetin alfa）。在給藥前，護理師應回報哪項評估發現？
A client with chronic kidney disease is prescribed epoetin alfa. Which assessment finding should the nurse report to the provider before administering the dose?
- ABlood pressure of 110/70 mmHg血壓 110/70 mmHg
- BHemoglobin level of 13.5 g/dL✓ 正解血紅素濃度 13.5 g/dL
- CHeart rate of 72 bpm心率 72 bpm
- DPotassium level of 4.8 mEq/L鉀離子濃度 4.8 mEq/L
— Explanation · 中文詳解 —
Epoetin alfa 的主要副作用之一是引發高血壓及增加血栓風險。當血紅素（Hb）達到或超過 11-12 g/dL 時，過度刺激骨髓可能導致高黏稠度血症，增加心肌梗塞或中風機率，故臨床上需嚴格監測 Hb 數值。
One of the principal adverse effects of epoetin alfa is the induction of hypertension and an increased risk of thrombosis. When the hemoglobin (Hb) reaches or exceeds 11-12 g/dL, excessive bone marrow stimulation can produce hyperviscosity, increasing the likelihood of myocardial infarction or stroke. For this reason, Hb values must be strictly monitored in clinical practice.
✦ 台美臨床差異
美台對慢性腎病病人的貧血治療指引目標相當一致，但台灣健保給付規定對於 Hb 數值要求更為嚴格。