— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備給予病人靜脈注射萬古黴素，給藥前最關鍵的評估指標為何？
A nurse is preparing to administer IV vancomycin to a client. Which nursing assessment is most critical prior to administration?
- AObtain current blood urea nitrogen (BUN) and creatinine levels✓ 正解取得目前的血液尿素氮（BUN）和肌酸酐數值
- BVerify the client's potassium level確認病人的血鉀濃度
- CAssess the client's peripheral pulse strength評估病人的周邊脈搏強度
- DCheck the client's current blood pressure檢查病人目前血壓
— Explanation · 中文詳解 —
萬古黴素具有顯著的腎毒性。在給藥前確認腎功能指標（BUN/Creatinine）是預防藥物累積導致急性腎損傷的標準作業。雖然此藥可能導致紅人症候群（血壓下降），但腎功能評估對於臨床安全用藥的調整劑量與毒性監測最為基礎。
Vancomycin has significant nephrotoxicity. Verifying renal function indicators (BUN/creatinine) before administration is the standard practice for preventing acute kidney injury due to drug accumulation. Although this medication may cause Red Man Syndrome (with hypotension), assessment of renal function is the most fundamental factor in safe dose adjustment and toxicity monitoring.
✦ 台美臨床差異
美國醫院藥師對於萬古黴素監測強度高，常依據血清藥物濃度（Trough）調整；台灣多由醫師調整。