— 藥理與非經腸給藥 · HARD · MCQ —
病人被開立萬古黴素（Vancomycin）1g IV Q12H。護理師應監測哪項檢驗數值以預防腎毒性？
A client is prescribed vancomycin 1g IV every 12 hours. Which laboratory value should the nurse monitor to prevent nephrotoxicity?
- ASerum creatinine✓ 正解血清肌酸酐
- BProthrombin time凝血酶原時間
- CSerum potassium血清鉀離子
- DWhite blood cell count白血球計數
— Explanation · 中文詳解 —
萬古黴素具有明確的腎毒性風險。血清肌酸酐（Creatinine）是評估腎絲球過濾功能的標準指標，隨著劑量累積，肌酸酐上升反映腎功能受損。此外，臨床常需監測藥物血中谷濃度（Trough level）以調整給藥劑量。
Vancomycin carries a well-documented risk of nephrotoxicity. Serum creatinine is the standard indicator of glomerular filtration function, and rising creatinine with cumulative dosing reflects renal impairment. In addition, monitoring trough serum drug levels is routinely needed to adjust the dose.
✦ 台美臨床差異
台美臨床對於 Vancomycin 均落實 Trough level 監測，台灣醫院常有專責藥師協助評估劑量。