一位感染 MRSA 的病人醫囑靜脈輸注萬古黴素（Vancomycin），下列哪項護理措施對預防輸注反應最重要？
A client is prescribed intravenous vancomycin for a MRSA infection. Which nursing intervention is most important to prevent infusion-related complications?
- AMonitor the infusion site for phlebitis hourly每小時監測輸注部位是否有靜脈炎
- BCheck peak and trough levels before every dose在每次給藥前檢查峰值和谷值濃度
- CPre-medicate with diphenhydramine預防性給予苯海拉明
- DAdminister the dose over a minimum of 60 minutes✓ 正解以至少60分鐘的時間給藥
萬古黴素若輸注過快，會導致紅人症候群（Red Man Syndrome），表現為臉部、頸部及軀幹潮紅、低血壓與搔癢，這是組織胺釋放造成的反應，非過敏。因此規定輸注時間至少 60 分鐘。B 雖重要但屬於監測毒性，A 是基礎護理，C 非預防紅人症候群的首選機制。
If vancomycin is infused too rapidly, it can cause Red Man Syndrome, manifested as facial, neck, and trunk flushing with hypotension and pruritus due to histamine release rather than true allergy. Therefore, the infusion time must be at least 60 minutes. Option B is important but pertains to monitoring for toxicity; option A is basic nursing care; option C is not the primary mechanism for preventing Red Man Syndrome.
台美皆嚴格規範萬古黴素滴注時間，但臨床上美國更頻繁使用藥劑師參與 TDM（治療藥物監測）評估。