— 藥理與非經腸給藥 · MEDIUM · MCQ —
病人因急性肺水腫被處方 furosemide 40 mg IV push。護理師應如何執行給藥？
A client is prescribed furosemide 40 mg IV push for acute pulmonary edema. How should the nurse administer this medication?
- AAdminister rapidly over 30 seconds在 30 秒內快速推注
- BAdminister via an IV bolus over 5 minutes在 5 分鐘內經靜脈推注
- CAdminister as a continuous infusion over 1 hour在 1 小時內持續輸注
- DAdminister at a rate of 20 mg per minute✓ 正解以每分鐘 20 mg 的速度給藥
— Explanation · 中文詳解 —
Furosemide 若推注速度過快，可能導致耳毒性（ototoxicity），如耳鳴、聽力喪失。臨床標準原則為每分鐘不超過 20 mg，因此 40 mg 應耗時至少兩分鐘給藥。A選項太快，B與C雖安全但非首選給藥方式，通常急性情況下推注需精確控制速率。
If furosemide is pushed too rapidly, it can cause ototoxicity, such as tinnitus or hearing loss. The clinical standard is not to exceed 20 mg per minute, so 40 mg should be administered over at least two minutes. Option A is too fast; options B and C, while safe, are not the preferred mode of administration, since acute situations typically require a precisely controlled push rate.
✦ 台美臨床差異
美台臨床對於給藥速率規範一致，但台灣護理紀錄會更詳實註記給藥時間與過後聽力評估。