— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備對傷口感染病人靜脈注射萬古黴素，哪項措施是預防輸注相關併發症的優先事項？
A nurse is preparing to administer IV vancomycin to a client with a wound infection. Which action is the priority to prevent infusion-related complications?
- AFlush the IV line with 0.9% normal saline before administration在給藥前以 0.9% 生理食鹽水沖洗靜脈管路
- BAssess the client for a history of penicillin allergy評估病人是否有盤尼西林過敏史
- CObtain a trough level before the first dose在第一劑給藥前取得谷濃度
- DDilute the medication and infuse over at least 60 minutes✓ 正解稀釋藥物並在至少 60 分鐘內輸注
— Explanation · 中文詳解 —
萬古黴素輸注速度過快會導致「紅人症候群」（Red Man Syndrome），表現為低血壓、臉部及頸部潮紅。為了避免此副作用，藥物必須充分稀釋並在至少 60 分鐘內緩慢輸注。其他選項雖為護理步驟，但針對該藥物特有之輸注反應，控制速率是預防的首要關鍵。
Rapid infusion of vancomycin can cause 'Red Man Syndrome,' characterized by hypotension and flushing of the face and neck. To avoid this reaction, the medication must be adequately diluted and infused slowly over at least 60 minutes. While the other actions are valid nursing steps, controlling the infusion rate is the priority for preventing this drug-specific infusion reaction.
✦ 台美臨床差異
美國醫院對萬古黴素輸注速度監測非常嚴格，台灣臨床常由藥劑部規範輸注時間。