— 藥理與非經腸給藥 · HARD · SATA —
病人獲開立靜脈輸注萬古黴素（Vancomycin）。護理師應執行下列哪項安全給藥措施？（選所有適合的）
A client is prescribed intravenous vancomycin. The nurse understands which of the following is an essential requirement for safe administration? (Select all that apply.)
- AInfuse the medication over at least 60 minutes✓ 正解至少以 60 分鐘的時間輸注藥物
- BMonitor for flushing, itching, or hypotension✓ 正解監測潮紅、搔癢或低血壓
- CCheck the trough level before the next dose✓ 正解在下一次給藥前檢查低谷濃度（trough level）
- DEnsure the intravenous line is patent to prevent infiltration✓ 正解確保靜脈通路暢通以防止滲漏
- EAdminister a rapid bolus to achieve therapeutic levels給予快速推注以達到治療濃度
— Explanation · 中文詳解 —
萬古黴素具有耳毒性與腎毒性，且快速輸注會引發紅人症候群（Red Man Syndrome），表現為潮紅與低血壓。給藥時必須緩慢滴注（至少 60 分鐘），並監測藥物谷濃度以維持治療範圍且避免毒性。若發生靜脈滲漏，因藥物具有組織腐蝕性，需立即處理。
Vancomycin is both ototoxic and nephrotoxic, and rapid infusion can precipitate Red Man Syndrome, manifested as flushing and hypotension. The medication must be infused slowly (over at least 60 minutes), and trough levels must be monitored to keep the drug within the therapeutic range while avoiding toxicity. Because the drug is tissue-corrosive, any IV extravasation must be addressed immediately.
✦ 台美臨床差異
美台皆嚴格執行萬古黴素濃度監測，但美國醫院內常見由臨床藥師協助計算劑量，台灣則較常由醫師或專科護理師評估。