一位 72 歲患有高血壓的客戶即將進行心導管檢查。在執行該程序前，護理師的首要護理措施為何？
A 72-year-old client with a history of hypertension is scheduled for a cardiac catheterization. Which nursing intervention is the highest priority before the procedure?
- AEnsure the client has signed the informed consent form確保病人已簽署知情同意書
- BPerform a baseline neurological assessment進行基線神經系統評估
- CAssess the client's allergy to shellfish or iodine✓ 正解評估病人是否對貝殼類或碘過敏
- DAdminister the prescribed pre-operative sedative給予處方之術前鎮靜劑
心導管檢查的核心風險在於顯影劑引起的過敏反應及腎毒性。碘顯影劑對 shellfish 或 iodine 過敏者具有高度風險，可能引發過敏性休克或急性腎衰竭。在進行任何處置前，確認過敏史是保護病人安全的第一道防線（Safety/Risk reduction）。雖然簽署同意書（A）是法律程序，給藥（D）是醫囑執行，神經評估（B）是例行檢查，但若病人對顯影劑過敏卻未被發現，上述動作都無法阻止災難發生。護理師必須在檢查前完成過敏評估並通報醫護團隊，這體現了預防性護理的核心精神，優先於程序性的行政步驟。
The core risks of cardiac catheterization are contrast-induced hypersensitivity reactions and nephrotoxicity. Iodinated contrast media pose a high risk for clients with shellfish or iodine allergy, potentially triggering anaphylactic shock or acute renal failure. Confirming allergy history before any procedure is the first line of defense for patient safety (safety / risk reduction). While signing the informed consent (A) is a legal process, administering a sedative (D) is following a medication order, and a neurological assessment (B) is a routine check, none of these actions can prevent a catastrophic outcome if a contrast allergy is missed. The nurse must complete the allergy assessment prior to the procedure and notify the team, reflecting the priority of preventive nursing over procedural administrative steps.
美國護理師在執行心導管前，必須核對過敏篩檢表及腎功能報告，若 eGFR < 60 則需與醫師確認是否預防性給予靜脈輸液；台灣則常見由麻醉科或放射科醫師在檢查前再做一次 double check，護理師的角色更強調檢查後的穿刺部位出血監控與末梢循環評估。