護理師正為一位 MRSA 病人施打萬古黴素（Vancomycin）靜脈滴注。15 分鐘後，病人面部與頸部出現劇烈潮紅。護理師首要行動為何？
A nurse is administering intravenous vancomycin to a client with MRSA. After 15 minutes, the client develops intense flushing of the face and neck. What is the nurse's priority action?
- ASlow the infusion rate and monitor the client✓ 正解減慢輸注速率並監測病人
- BDocument the reaction as an allergy to vancomycin將此反應記錄為對萬古黴素的過敏
- CStop the infusion and notify the physician停止輸注並通知醫師
- DAdminister PRN diphenhydramine intramuscularly肌肉注射備用劑量的苯海拉明
此臨床表現典型為「紅人症候群（Red Man Syndrome）」，這並非真正的 IgE 介導過敏反應，而是由於滴注速度過快導致肥大細胞直接釋放組織胺所致。處置原則是「減慢速度」而非立即停藥（除非伴隨呼吸困難或低血壓等過敏性休克徵兆）。核心概念：區分輸注反應與過敏反應。正確答案是 A，將滴注時間延長至至少 60-90 分鐘通常可緩解症狀。若選擇 C（停止），會延誤抗生素治療，除非病人有生命危險。若選擇 D（記錄為過敏），會導致病人未來被錯誤地標記為無法使用此重要藥物。臨床思路在於識別藥物副作用的機轉並採取正確的技術性調整。
This presentation is typical of Red Man Syndrome, which is not an IgE-mediated allergic reaction but rather direct histamine release from mast cells due to rapid infusion. The principle is to 'slow the rate' rather than immediately stopping (unless accompanied by dyspnea or hypotension signaling anaphylaxis). Differentiate infusion reaction from allergy. The correct answer is A; extending infusion time to at least 60-90 minutes usually relieves symptoms. Choosing C (stop) delays antibiotic therapy unless there is a life-threatening emergency. Choosing D (document as allergy) will incorrectly label the client and restrict future use of this important medication.
美國護理標準明確區分輸注反應與 Anaphylaxis，護理師常有權限依 Protocol 調整速度；台灣臨床實務中，護理師通常會先停掉滴注並立即回報醫師，等待進一步指示後才調整速度。