— 藥理與非經腸給藥 · HARD · MCQ —
病人正接受靜脈注射苯妥英（Phenytoin）以控制癲癇。下列哪項護理行動最重要？
A client is receiving phenytoin intravenously for seizure control. Which nursing action is essential?
- AInfuse through a central line only僅透過中心靜脈導管輸注
- BAdminister at a rate of 100 mg per minute以每分鐘 100 mg 的速率給藥
- CMonitor for cardiac arrhythmias✓ 正解監測心律不整
- DDilute with dextrose 5% in water以 5% 葡萄糖水稀釋
— Explanation · 中文詳解 —
Phenytoin 靜脈注射與心血管穩定性高度相關。其不可溶於葡萄糖液（會結晶）（D），給藥速度極限為 50 mg/min（B），超過此速度易引發低血壓與心律不整（C）。雖然建議大血管輸注，但並非限定僅限中央靜脈（A）。
IV phenytoin closely affects cardiovascular stability. It precipitates in dextrose (D is wrong) and the maximum infusion rate is 50 mg/min (B is wrong); exceeding this rate causes hypotension and dysrhythmias, so cardiac monitoring is essential. Large peripheral veins are acceptable, so it is not restricted to central lines (A).
✦ 台美臨床差異
兩地均高度重視靜脈給藥速度限制，常規設定為 50mg/min，以防止嚴重心律不整。