— 照護管理 · MEDIUM · MCQ —
護理師正在收納一位患有鬱血性心臟衰竭（CHF）的病人，病人出現呼吸困難和肺部囉音。下列哪種藥物最可能被優先給予？
A nurse is admitting a client with congestive heart failure (CHF) who is experiencing dyspnea and crackles in the lungs. Which medication is most likely to be administered first?
- ALisinopril (ACE inhibitor)Lisinopril (ACE 抑制劑)
- BMetoprolol (beta-blocker)Metoprolol (乙型阻斷劑)
- CWarfarin (anticoagulant)Warfarin (抗凝血劑)
- DFurosemide (loop diuretic)✓ 正解Furosemide (環狀利尿劑)
— Explanation · 中文詳解 —
鬱血性心臟衰竭（CHF）病人出現呼吸困難與肺部囉音（Crackles），表示存在明顯的體液滯留與肺水腫，心臟負荷過重。利尿劑（如 Furosemide）能快速排除體內過多的水分與鈉，有效減輕心臟前負荷，是緩解 CHF 急性症狀的首選藥物。其他藥物（如 Beta-blocker、ACEI）則主要用於長期心臟功能管理，而非急性肺水腫的緩解。
CHF with dyspnea and crackles indicates fluid overload and pulmonary edema with excess cardiac load. Loop diuretics like furosemide rapidly remove excess fluid and sodium, reducing preload and relieving acute symptoms — the first-line agent for acute CHF decompensation. Other drugs (beta-blockers, ACE inhibitors) are for long-term management, not acute pulmonary edema relief.