— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師衛教一位剛開始服用左旋甲狀腺素（Levothyroxine）的病人，下列哪些敘述顯示病人需要進一步教育？（選所有適合的）
A nurse is educating a client starting on levothyroxine. Which statements by the client indicate a need for further teaching? (Select all that apply.)
- AI should take this medication on an empty stomach.我應該空腹服用此藥物。
- BI will take my calcium supplement at the same time as my thyroid pill.✓ 正解我會與甲狀腺藥物同時服用鈣補充劑。
- CI should report symptoms of a rapid heartbeat to my doctor.我應該向醫師報告心跳加速的症狀。
- DI can stop the medication once my blood levels are normal.✓ 正解一旦我的血液指標正常，我可以停止用藥。
- EIt may take several weeks to notice the full effect of the medication.可能需要幾週時間才能注意到藥物的完全效果。
— Explanation · 中文詳解 —
甲狀腺素需長期補充，不可自行停藥（D 錯誤）。藥物吸收極易受鈣質、鐵劑、制酸劑影響，應間隔至少 4 小時服用（B 錯誤）。Levothyroxine 應空腹使用（A 正確），心跳過快是藥物過量警訊需回報（C 正確），藥效發揮緩慢需耐心服藥（E 正確）。
Thyroid hormone replacement is lifelong and must not be discontinued (D is incorrect). Absorption is markedly affected by calcium, iron, and antacids, which must be separated by at least 4 hours (B is incorrect). Levothyroxine should be taken on an empty stomach (A correct), rapid heartbeat is a sign of overdose to report (C correct), and full effects take several weeks to appear (E correct).
✦ 台美臨床差異
台美皆強調藥物交互作用。在台灣，因許多民眾習慣併用中藥或保健品，衛教時需更主動詢問並提醒鈣片與鐵劑的避開時機。