— 藥理與非經腸給藥 · EASY · MCQ —
一位接受肝素點滴的病人，哪項評估結果需要立即介入？
Which assessment finding in a client receiving an IV heparin drip requires immediate intervention?
- ABruising at the IV site靜脈注射部位出現瘀青
- BPlatelet count of 150,000/mm³血小板計數為 150,000/mm³
- CGum bleeding when brushing teeth✓ 正解刷牙時牙齦出血
- DAPTT 70 seconds活化部分凝血活酶時間 (APTT) 為 70 秒
— Explanation · 中文詳解 —
肝素治療期間，牙齦出血代表凝血功能過度抑制，屬於急性出血徵象，需立即停藥並評估。A 的數值在治療範圍內；C 是常見的皮下出血，需觀察但不如活動性黏膜出血危急；D 為正常範圍，不代表有肝素引起的血小板減少症。
During heparin therapy, gum bleeding represents excessive suppression of clotting and is a sign of active bleeding that requires immediate discontinuation of the infusion and reassessment. Option D is within the therapeutic range; option A reflects common subcutaneous bruising that warrants observation but is less urgent than active mucosal bleeding; option B is within the normal range and does not indicate heparin-induced thrombocytopenia.
✦ 台美臨床差異
美國多由護理師依據 protocol 自行調整劑量，台灣則多需醫師根據實驗室數據開立醫囑後調整。