護理師正準備給予萬古黴素（vancomycin）的靜脈輸注。病人有腎臟疾病病史。最重要的護理考量是什麼？
A nurse is preparing to administer an IV infusion of vancomycin. The client has a history of kidney disease. What is the most important nursing consideration?
- AAdminister the medication over at least 60 minutes.以至少 60 分鐘的時間給藥。
- BEncourage increased fluid intake.鼓勵增加水分攝取。
- CMonitor for signs of Red Man Syndrome.監測紅人症候群的跡象。
- DMonitor serum drug levels and renal function.✓ 正解監測血清藥物濃度和腎功能。
萬古黴素（Vancomycin）主要經由腎臟排泄。對於腎功能不全的病人，藥物清除率下降，極易導致血中濃度過高，進而引發腎毒性或耳毒性（Ototoxicity）。因此，臨床上必須定期監測血中藥物濃度（Trough levels）以及腎功能指標（Creatinine, GFR），以精確調整給藥劑量，確保藥物在治療窗內且不傷害腎臟。
Vancomycin is excreted primarily through the kidneys. In clients with renal impairment, decreased drug clearance can produce excessively high serum levels, increasing the risk of nephrotoxicity and ototoxicity. Therefore, serum drug levels (trough levels) and renal function parameters (creatinine, GFR) must be monitored regularly to titrate the dose precisely, keeping the drug within its therapeutic window without further damaging the kidneys.