護理師準備為病人給予靜脈注射抗生素，哪項行動是確保安全並預防潛在併發症的優先事項？

核心概念：靜脈藥物治療的安全措施，特別是給藥前的關鍵評估。 為何正確答案對： D. 檢視病人的過敏史：給予靜脈注射抗生素（intravenous antibiotic）具有潛在的嚴重過敏反應風險，包括可能致命的過敏性休克（anaphylactic shock）。在給藥前，最優先且最關鍵的安全措施是確認病人是否對該抗生素或其成分有任何已知的過敏史。若病人有過敏史，應立即停止給藥，並通知醫師，尋找替代藥物或採取預防措施。 為何其他選項錯： D. 檢查藥物有效期限：檢查藥物有效期限（expiration date）是標準的給藥安全措施，確保藥物在效期內，但相較於潛在的致命過敏反應，其優先級稍低。過期藥物可能藥效降低或產生有害物質，但通常不如嚴重過敏反應那樣危及生命。 B. 使用兩種識別方式確認病人身份：這是「五對」給藥原則（Five Rights of Medication Administration）中的一項重要安全措施，用於確保給予正確的病人。雖然極其重要，但對於靜脈抗生素這類高風險藥物，過敏史的評估直接關係到病人是否能安全地接受該藥物，是更為首要的考量。 C. 評估靜脈輸注部位的通暢性：評估靜脈輸注（intravenous infusion）部位的通暢性（patency）是確保藥物能順利進入血管、預防滲漏（infiltration）或靜脈炎（phlebitis）的重要步驟。然而，即使部位通暢，若病人對藥物過敏，給藥仍是危險的。 臨床思路：此題考量「減低風險潛力」（Reduction of Risk Potential）領域，重點在於藥物安全的「優先順序」。在給予靜脈抗生素這類可能引發嚴重不良反應的藥物時，ABC 原則中的 A（Airway）和 B（Breathing）的潛在威脅（過敏性休克影響呼吸道和循環）需要被最優先排除。因此，評估過敏史是確保病人安全接受藥物的首要步驟。

Core concept: safety measures for intravenous medication therapy, particularly the critical assessments performed before administration. Why the correct answer is right: D. Reviewing the client's allergy history: Administration of an intravenous antibiotic carries the potential risk of serious allergic reactions, including life-threatening anaphylactic shock. Before administration, the most urgent and critical safety measure is to confirm whether the client has any known allergy to the antibiotic or its components. If an allergy history is present, administration must be stopped immediately, the provider notified, and an alternative medication or preventive measures sought. Why the other options are wrong: A. Checking the medication's expiration date: Verifying the expiration date is a standard medication safety practice that ensures the drug is still within its shelf life, but it is of slightly lower priority compared with a potentially fatal allergic reaction. Expired medications may have reduced potency or produce harmful byproducts, but they are usually not as immediately life-threatening as a severe allergic reaction. B. Verifying the client's identity using two identifiers: This is an essential safety measure within the Five Rights of Medication Administration that ensures the medication is given to the correct client. Although extremely important, for high-risk medications such as an intravenous antibiotic, allergy assessment is directly tied to whether the client can safely receive the drug and is therefore the more primary consideration. C. Assessing the patency of the IV site: Evaluating the patency of the intravenous infusion site is an important step to ensure the medication enters the vessel smoothly and to prevent infiltration or phlebitis. However, even if the site is patent, administration is still dangerous if the client is allergic to the drug. Clinical reasoning: This item falls within the Reduction of Risk Potential domain and focuses on prioritization of medication safety. When administering an intravenous antibiotic that can provoke severe adverse reactions, potential threats to A (Airway) and B (Breathing) within the ABC framework (anaphylactic shock affecting airway and circulation) must be ruled out first. Therefore, reviewing the allergy history is the first step to ensure the client can safely receive the medication.