護理師正為一位 MRSA 感染病人靜脈注射萬古黴素（Vancomycin）。注射 15 分鐘後，病人頸部與臉部出現嚴重發紅。護理師的優先處置為何？
A nurse is administering intravenous (IV) vancomycin to a client with MRSA. After 15 minutes, the client develops intense flushing of the neck and face. Which action is the nurse's priority?
- AAdminister intramuscular epinephrine給予肌肉注射腎上腺素
- BStop the infusion immediately and notify the healthcare provider立即停止輸注並通知醫療提供者
- CApply cold compresses to the affected areas在受影響區域應用冷敷
- DSlow the infusion rate and monitor the client✓ 正解減慢輸注速率並監測病人
此症狀描述的是典型的「紅人症候群（Red Man Syndrome）」，這不是真正的過敏反應，而是因為萬古黴素滴注速度過快，刺激肥大細胞直接釋放組織胺所致。核心處置是將滴注時間延長（通常建議至少 60 分鐘以上）。正確答案 D 是首選，因為減慢速度通常能緩解症狀，且不需要完全停藥。若症狀嚴重，可醫囑給予抗組織胺（如 Benadryl）。區分「紅人症候群」與「過敏性休克（Anaphylaxis）」是關鍵：前者通常只有發紅且無呼吸道症狀或低血壓；後者則需立即停藥並給予強心針。此題考驗護理師對藥物特定副作用與處置策略的辨識力。
The symptoms described represent the classic 'Red Man Syndrome,' which is not a true allergic reaction but rather results from rapid infusion of vancomycin causing direct mast cell histamine release. The core intervention is to extend the infusion time (usually recommended to be at least 60 minutes or longer). The correct answer is D, because slowing the rate usually relieves the symptoms and complete discontinuation of the medication is not necessary. If symptoms are severe, an antihistamine such as diphenhydramine (Benadryl) may be ordered. Distinguishing Red Man Syndrome from anaphylaxis is key: the former generally shows only flushing without respiratory symptoms or hypotension, whereas the latter requires immediate discontinuation and administration of epinephrine. This question tests the nurse's ability to recognize a drug-specific adverse effect and the corresponding management strategy.
美國 NCLEX 考題中，「Red Man Syndrome」是 Vancomycin 的必考點，強調「Slow the rate」。台灣臨床實務中，若看到病人發紅，護理師通常會非常緊張而直接關掉點滴並叫醫師，對於「減慢速度繼續給藥」的接受度較低，常傾向視為過敏。