— 降低風險 · HARD · SATA —
病人預計進行需施打對比劑的診斷檢查，下列哪些發現需立即回報醫師？（選所有適合的）
A client is scheduled for a diagnostic procedure involving IV contrast dye. Which assessment findings should the nurse report to the provider immediately? (Select all that apply.)
- AHistory of allergy to shellfish✓ 正解有貝類過敏史
- BSerum creatinine level of 2.5 mg/dL✓ 正解血清肌酸酐值為 2.5 mg/dL
- CTaking metformin daily✓ 正解每日服用 Metformin
- DHistory of claustrophobia有幽閉恐懼症病史
- ESerum potassium level of 4.2 mEq/L血清鉀值為 4.2 mEq/L
— Explanation · 中文詳解 —
對比劑具腎毒性，肌酸酐 2.5 mg/dL 代表腎功能不佳，屬高風險。二甲雙胍（Metformin）與對比劑併用可能引發乳酸中毒，需暫停使用。對海鮮過敏者常伴隨對碘過敏。至於幽閉恐懼症通常只需給予鎮靜劑，鉀離子 4.2 屬正常範圍。
Contrast media are nephrotoxic; a creatinine of 2.5 mg/dL indicates impaired renal function and high risk. Metformin combined with contrast may precipitate lactic acidosis and must be withheld. Shellfish allergy is often associated with iodine sensitivity. Claustrophobia is usually managed with sedation, and a potassium of 4.2 mEq/L is within normal range.
✦ 台美臨床差異
台灣針對 Metformin 的停藥規範（通常術前 48 小時）遵循國際準則，美國亦然。