— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備靜脈推注 Phenytoin。為預防併發症，應採取何項行動？
A nurse is preparing to administer phenytoin via IV push. Which action should the nurse take to prevent complications?
- AMonitor for hypertension during the infusion在輸注期間監測高血壓
- BDilute the medication in 100 mL of 0.9% Normal Saline將藥物稀釋於 100 mL 的 0.9% 生理鹽水中
- CAdminister at a rate not exceeding 50 mg/min✓ 正解以不超過 50 mg/min 的速度給藥
- DFlush the IV line with Dextrose 5% in water before administration在給藥前以 5% 葡萄糖溶液沖洗靜脈管路
— Explanation · 中文詳解 —
Phenytoin 靜脈推注時，速度過快易引起低血壓或心律不整，必須嚴格控制速率在 50 mg/min 以下。且 Phenytoin 具高度刺激性，與葡萄糖液混合會產生結晶，因此不可用 D5W 沖管，應使用生理食鹽水。此藥物需經由大血管給予，避免引起紫手套症候群。
IV phenytoin must be administered slowly (not exceeding 50 mg/min) to prevent hypotension and cardiac dysrhythmias. Phenytoin is also incompatible with dextrose solutions (crystal formation) and must be flushed with normal saline. It should be given through a large vein to avoid purple glove syndrome.
✦ 台美臨床差異
台灣醫院多有嚴格的給藥速率警示系統，美國則更強調護理師親自進行速率計算與核對。