病人因 MRSA 感染被開立萬古黴素（Vancomycin）。護理師準備給藥時，哪項評估對於預防副作用最重要？
A client is prescribed vancomycin for a MRSA infection. The nurse is preparing to administer the dose. Which assessment is most important to prevent adverse effects?
- ACheck for recent creatinine and BUN levels✓ 正解檢查最近的肌酸酐和 BUN 數值
- BVerify the presence of a central venous line確認是否存在中心靜脈導管
- CEnsure the medication is administered as a bolus dose確保藥物以推注方式給藥
- DAssess the client for a history of penicillin allergy評估個案是否有青黴素過敏史
萬古黴素具有顯著的腎毒性。在給藥前確認病人的肌酸酐與血中尿素氮數值，可協助醫師評估腎功能狀況並調整劑量或輸注頻率。給藥過快常引起紅人症（Red Man Syndrome），故應緩慢輸注，而非推注（Bolus）。雖然需評估過敏，但腎功能監測對於這類藥物安全性至關重要。
Vancomycin is significantly nephrotoxic. Verifying the client's creatinine and BUN levels before administration helps the provider assess renal function and adjust the dose or infusion frequency. Rapid administration commonly causes Red Man Syndrome, so the drug must be infused slowly rather than as a bolus. Although allergy assessment is necessary, monitoring renal function is crucial to the safety of this medication.
台美均嚴格執行腎功能監測，但美國醫院常配置藥師監測 Vancomycin 谷濃度（Trough level）以精準給藥。