一位 50 歲個案因物質戒斷入院。哪項評估發現需要立即的護理介入？
A 50-year-old client is admitted for substance withdrawal. Which assessment finding requires immediate nursing intervention?
- AMild diaphoresis輕微出汗
- BMild hand tremors輕微手部震顫
- CVisual hallucinations✓ 正解視幻覺
- DAnxiety and irritability焦慮與易怒
物質戒斷（特別是酒精）的進程中，幻覺（Hallucinations）通常預示著「戒斷譫妄（Delirium Tremens, DTs）」的發生，這是致命的醫療緊急狀況。DTs 常伴隨高血壓、心跳過速、高熱與意識障礙，若不立即介入，個案極可能出現癲癇發作或循環衰竭。因此，幻覺出現時需立即回報醫師並採取嚴密的生理監測。
During substance withdrawal (especially alcohol), hallucinations often herald the onset of delirium tremens (DTs), a life-threatening medical emergency. DTs are commonly accompanied by hypertension, tachycardia, hyperthermia, and altered consciousness; without immediate intervention, the patient is at high risk of seizures or circulatory collapse. Therefore, when hallucinations appear, the physician must be notified at once and close physiologic monitoring must be initiated.