— 藥理與非經腸給藥 · HARD · SATA —
護理師準備以靜脈推注方式給予苯妥英（Phenytoin）。應採取哪些護理措施？（選所有適合的）
A nurse is preparing to administer phenytoin via IV bolus. Which interventions are appropriate? (Select all that apply.)
- ADilute the medication with 0.9% Normal Saline✓ 正解以 0.9% 生理食鹽水稀釋藥物
- BAdminister at a rate not exceeding 50 mg/min✓ 正解給藥速率不得超過 50 mg/min
- CMonitor for cardiac arrhythmias during infusion✓ 正解輸注期間監測心律不整
- DFlush the IV line with Dextrose 5% in water before administration給藥前以 5% 葡萄糖水沖洗靜脈通路
- EAssess for local tissue necrosis at the injection site✓ 正解評估注射部位是否有局部組織壞死
— Explanation · 中文詳解 —
Phenytoin 靜脈給藥極易產生不相容性。應使用 0.9% 生理食鹽水稀釋，因為它在葡萄糖溶液中會結晶。給藥速度過快可能導致低血壓或心律不整，上限為 50 mg/min。此外，藥物具有強鹼性，滲漏會導致嚴重的組織壞死，故需嚴密監控輸注部位。
Phenytoin administered intravenously is highly prone to incompatibility issues. It should be diluted with 0.9% normal saline because it crystallizes in dextrose solutions. Administering it too rapidly may cause hypotension or arrhythmias; the maximum rate is 50 mg/min. In addition, the drug is strongly alkaline, and extravasation can cause severe tissue necrosis; therefore, the infusion site must be closely monitored.
✦ 台美臨床差異
美台給藥規範一致，但美國醫院常配置專屬抗癲癇藥物輸注清單。