— 藥理與非經腸給藥 · HARD · SATA —
護理師準備經由靜脈點滴給予苯妥英鈉（Phenytoin）。下列哪些護理措施是正確的？（選所有適合的）
A nurse is preparing to administer phenytoin via IV piggyback. Which nursing actions 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✓ 正解給藥速度不得超過 50 mg/min
- CFlush the IV line with 5% Dextrose before administration給藥前以 5% 葡萄糖液沖洗靜脈管路
- DUse an in-line filter for administration✓ 正解給藥時使用線上過濾器
- EMonitor blood pressure and ECG during infusion✓ 正解輸注期間監測血壓和心電圖
— Explanation · 中文詳解 —
苯妥英鈉極易結晶，僅能與生理食鹽水稀釋，且若接觸葡萄糖溶液（D5W）會產生沉澱。給藥速度過快會引發低血壓與心律不整，因此需嚴格控制在 50 mg/min 以下。使用過濾器可減少沉澱物進入血管，監測生命徵象是為了預防藥物副作用。
Phenytoin crystallizes readily and can only be diluted with normal saline; contact with dextrose solutions (D5W) leads to precipitation. Administration that is too rapid causes hypotension and arrhythmia, so the infusion rate must be strictly controlled to no more than 50 mg/min. An in-line filter helps to keep precipitates from entering the vasculature, and vital sign monitoring is used to detect adverse drug effects.
✦ 台美臨床差異
兩地皆嚴格要求與葡萄糖溶液分開，但在美國常有專門的 IV protocol 規範給藥速度。