— 藥理與非經腸給藥 · HARD · MCQ —
護理師正在照護一位服用口服阿托伐他汀（atorvastatin）的病人。病人報告嚴重肌肉疼痛與深色尿液。首要的護理措施為何？
A nurse is caring for a client taking oral atorvastatin. The client reports severe muscle pain and dark urine. What is the priority nursing action?
- AAdminister a dose of pain medication.給予一劑止痛藥。
- BHold the medication and notify the physician.✓ 正解暫停藥物並通知醫師。
- CEncourage the client to increase fluid intake.鼓勵病人增加水分攝取。
- DContinue the medication and monitor symptoms.繼續用藥並監測症狀。
— Explanation · 中文詳解 —
嚴重的肌肉疼痛（myalgia）合併深色尿液（dark urine）為橫紋肌溶解症（rhabdomyolysis）的典型臨床表現，這是 statin 類藥物（如 atorvastatin）最嚴重的副作用。橫紋肌溶解可能造成肌紅蛋白尿，進而引發急性腎損傷。護理師必須立即「停止給藥」並通知醫師，安排 CK、肌紅蛋白與腎功能檢驗。注意：atorvastatin 為口服藥，臨床上無 IV 劑型。
Severe muscle pain with dark urine is a classic presentation of rhabdomyolysis, the most serious adverse effect of statins such as atorvastatin. Rhabdomyolysis can cause myoglobinuria and acute kidney injury. The nurse must hold the drug immediately and notify the provider so CK, myoglobin, and renal function tests can be ordered. Note: atorvastatin is oral; no IV formulation exists.