— 藥理與非經腸給藥 · HARD · SATA —
護理師準備發藥。下列哪些狀況在給藥前應先聯絡開立處方的醫師？（選所有適合的）
A nurse is preparing to administer several medications. For which client should the nurse contact the prescriber before administering the medication? (Select all that apply.)
- AClient with a heart rate of 52 bpm prescribed digoxin✓ 正解心率 52 bpm 且處方地高辛的病人
- BClient with a blood pressure of 110/70 mmHg prescribed lisinopril血壓 110/70 mmHg 且處方 lisinopril 的病人
- CClient with a blood glucose of 65 mg/dL prescribed insulin glargine✓ 正解血糖 65 mg/dL 且處方 insulin glargine 的病人
- DClient with a potassium level of 5.8 mEq/L prescribed spironolactone✓ 正解鉀離子濃度 5.8 mEq/L 且處方 spironolactone 的病人
- EClient with a fever of 38.5 C prescribed ibuprofen發燒 38.5 C 且處方 ibuprofen 的病人
— Explanation · 中文詳解 —
護理師需運用批判性思維執行安全給藥。地高辛（Digoxin）心跳過慢（<60 bpm）需停藥；血糖 65 mg/dL 過低，給長效胰島素恐致嚴重低血糖；螺內酯（Spironolactone）屬保鉀利尿劑，高血鉀時給藥危險。BP 110/70 和發燒給藥通常在安全範圍內。
The nurse must use critical thinking for safe medication administration. Hold digoxin and notify the provider if HR < 60 bpm; glucose 65 mg/dL is too low for long-acting insulin and risks severe hypoglycemia; spironolactone is potassium-sparing and dangerous with hyperkalemia. BP 110/70 and fever are within safe limits for the medications listed.
✦ 台美臨床差異
台美皆依據給藥安全 protocol，但美國常有自動化系統提示 (CDSS)，台灣則較仰賴護理師的臨床藥學知識判斷。