— 藥理與非經腸給藥 · HARD · SATA —
靜脈輸注 Phenytoin 時，哪些護理考量是必要的？（選所有適合的）
Which nursing considerations are essential when administering phenytoin intravenously? (Select all that apply.)
- AAdminister only with 0.9% Normal Saline✓ 正解僅使用 0.9% 生理食鹽水給藥
- BMonitor for cardiac arrhythmias during infusion✓ 正解輸注期間監測心律不整
- CEnsure the infusion rate does not exceed 50 mg/min✓ 正解確保輸注速率不超過 50 mg/min
- DUse a large-bore needle for peripheral access✓ 正解使用大管徑針頭進行周邊靜脈通路
- EFlush the line with Dextrose 5% in water before administration給藥前用 5% 葡萄糖水沖洗管路
— Explanation · 中文詳解 —
Phenytoin 具高度刺激性，僅能與生理食鹽水 (NS) 配伍，若接觸 Dextrose 會產生沉澱。輸注速度過快會引發嚴重的心律不整與低血壓，成人速率不得超過 50 mg/min。因其具組織毒性，建議使用大管徑周邊靜脈以利稀釋及防止滲漏。
Phenytoin is highly irritating and compatible only with 0.9% normal saline (NS); contact with dextrose causes precipitation. Excessive infusion rates can produce severe arrhythmias and hypotension, and in adults the rate must not exceed 50 mg/min. Because of its tissue toxicity, a large-bore peripheral vein is recommended to facilitate dilution and reduce the risk of extravasation.
✦ 台美臨床差異
台美對 Phenytoin 的相容性與給藥速度規定一致，但台灣臨床偏好使用中央靜脈導管給予，以進一步降低周邊靜脈炎風險。