— 藥理與非經腸給藥 · HARD · SATA —
護理師準備發藥。下列哪些病人應優先評估？（選所有適合的）
A nurse is preparing to administer several medications. Which client should the nurse see first? (Select all that apply.)
- AA client receiving vancomycin with a new rash on the upper torso✓ 正解上身出現新皮疹且正在接受萬古黴素治療的病人
- BA client on digoxin with a heart rate of 52 beats/min✓ 正解心率為 52 次/分且正在接受地高辛治療的病人
- CA client on lisinopril reporting a dry cough報告乾咳且正在接受 lisinopril 治療的病人
- DA client on metformin scheduled for a contrast imaging study✓ 正解安排進行對比劑影像檢查且正在接受 metformin 治療的病人
- EA client on levothyroxine asking about taking the medication at night詢問是否可在夜間服藥且正在接受 levothyroxine 治療的病人
— Explanation · 中文詳解 —
應優先評估具潛在生命威脅的狀況：A 可能為輸注症候群或過敏，需立即處理；B 心跳過慢（小於 60）為毛地黃毒性徵兆；D 二甲雙胍在放射檢查需停藥以防乳酸中毒。C 為常見副作用，不緊急；E 為衛教議題，非急性護理需求。
Clients with potential life-threatening conditions should be assessed first: A may represent infusion-related syndrome or an allergic reaction and requires immediate management; B - bradycardia (less than 60 bpm) - is a sign of digoxin toxicity; D - metformin must be held before contrast imaging to prevent lactic acidosis. Option C is a common medication side effect and not urgent; option E concerns medication timing education and is not an acute care need.
✦ 台美臨床差異
美國護理師有權依醫囑暫停高警訊藥物，台灣法規較嚴格，通常需先通知醫師確認後才執行停藥動作。