病人獲開立 Doxorubicin。護理師的優先評估是什麼？
A client is prescribed Doxorubicin. What is the nurse's priority assessment?
- ABlood glucose血糖
- BSkin rash皮膚紅疹
- CHeart failure signs (e.g., crackles, edema)✓ 正解心衰竭徵象（例如：濕囉音、水腫）
- DUrine color尿液顏色
Doxorubicin（Adriamycin）屬於蒽環類（Anthracyclines）化療藥物，其臨床使用受限於嚴重的累積性心臟毒性（Cardiotoxicity）。此藥可導致心肌細胞受損，進而引發擴張性心肌病變與充血性心衰竭（CHF）。護理重點在於監測心臟衰竭的早期徵兆，如肺部濕囉音（Crackles）、周邊水腫、頸靜脈怒張或體重快速增加。在給藥前，必須確認病人的心臟射出分率（LVEF）是否在安全範圍內，以預防不可逆的心臟損傷。
Doxorubicin (Adriamycin) is an anthracycline chemotherapeutic agent whose clinical use is limited by severe cumulative cardiotoxicity. The drug can damage myocardial cells, leading to dilated cardiomyopathy and congestive heart failure (CHF). The nursing focus is on monitoring for early signs of heart failure, such as pulmonary crackles, peripheral edema, jugular venous distention, and rapid weight gain. Before administration, the patient's left ventricular ejection fraction (LVEF) must be confirmed to be within a safe range in order to prevent irreversible cardiac injury.
在美國臨床執業中，給藥前必須依據醫囑執行超音波心圖（Echocardiogram）監測 LVEF，若數值低於特定閾值（通常為 50%-55%），護理師須立即通知腫瘤科醫師，並可能需要停藥。