護理師為高血壓病人進行藥物整合,下列哪些藥物可能升高血壓,需與醫師討論?(選所有適合的)
A nurse is conducting a medication reconciliation for a client with a history of hypertension. Which medications should the nurse discuss with the provider as potentially increasing blood pressure? (Select all that apply.)
- ANonsteroidal anti-inflammatory drugs (NSAIDs)✓ 正解非類固醇消炎藥 (NSAIDs)
- BPseudoephedrine✓ 正解偽麻黃鹼
- CAcetaminophen乙醯胺酚
- DOral contraceptives✓ 正解口服避孕藥
- ESteroidal anti-inflammatory drugs✓ 正解類固醇消炎藥
多種非處方藥與長期用藥會干擾血壓控制。NSAIDs 透過減少腎臟前列腺素導致水鈉滯留;Pseudoephedrine 為擬交感神經劑,會使血管收縮;口服避孕藥可能引起血管收縮或體液滯留;類固醇藥物亦會導致水鈉滯留而升高血壓。乙醯胺酚對血壓影響極小,通常安全。
Many over-the-counter and long-term medications interfere with blood pressure control. NSAIDs decrease renal prostaglandins, leading to sodium and water retention; pseudoephedrine is a sympathomimetic that causes vasoconstriction; oral contraceptives can induce vasoconstriction or fluid retention; and corticosteroids likewise cause sodium and water retention with elevated blood pressure. Acetaminophen has minimal effect on blood pressure and is generally safe.
美國護理師常教導藥物整合(Medication Reconciliation),台灣主要由藥師進行整合,護理師則負責執行醫師決策。