病人預計進行含顯影劑的電腦斷層 (CT) 掃描。護理師應優先向醫療團隊回報哪項評估發現？

含碘顯影劑具有高度的腎毒性，主要經由腎臟排泄。肌酸酐 (Creatinine) 是評估腎功能最直接的指標，正常值約為 0.6-1.2 mg/dL。當肌酸酐達到 2.8 mg/dL 時，顯示病人存在顯著的腎功能不全（CKD 或急性損傷），此時使用顯影劑極可能誘發顯影劑腎病變 (Contrast-Induced Nephropathy, CIN)，導致急性腎衰竭。因此，這是安全上的最優先考量。雖然幽閉恐懼症（C）需要處理（可能需鎮靜），血壓高（D）需要監測，但都沒有腎衰竭的風險那麼急迫且具有不可逆性。過往認為貝類過敏（與碘相關）重要，但目前的實證醫學更強調腎功能監測與顯影劑過敏史。護理師在術前準備中扮演著風險攔截者的角色。

Iodinated contrast media are highly nephrotoxic and are primarily excreted by the kidneys. Creatinine is the most direct indicator of renal function, with a normal range of approximately 0.6–1.2 mg/dL. A creatinine of 2.8 mg/dL indicates significant renal insufficiency (CKD or acute injury); using contrast in this setting may readily induce contrast-induced nephropathy (CIN) and result in acute renal failure. Therefore, this is the top safety priority. Although claustrophobia (C) needs to be addressed (possibly with sedation), and high blood pressure (D) requires monitoring, neither is as urgent or as irreversible as the risk of renal failure. Although shellfish allergy (related to iodine) was once considered important, current evidence-based medicine emphasizes renal-function monitoring and a history of contrast allergy. In preoperative preparation, the nurse plays the role of risk gatekeeper.

美國護理實務強調術前清單 (Checklist) 的獨立執行力，護理師若發現肌酸酐異常有權利直接延後檢查並通知放射科；台灣則多由放射科櫃檯先審核數據，若護理師未發現，通常在傳送至放射科後才會被攔截。