護理師準備為病人靜脈輸注萬古黴素（Vancomycin）。輸注前最重要的護理評估為何，以確保病人安全？
A nurse is preparing to administer IV vancomycin to a client. Which nursing assessment is most critical prior to infusion to ensure patient safety?
- AReview the client's dietary preferences檢視病人的飲食偏好
- BVerify the most recent serum creatinine and trough level✓ 正解確認最近的血清肌酸酐和谷濃度
- CCheck the client's current potassium level檢查病人目前的鉀離子水平
- DAssess the peripheral site for phlebitis評估周邊穿刺部位是否有靜脈炎
萬古黴素具腎毒性與耳毒性，給藥前必須確保腎功能正常（肌酸酐）以及血中濃度（Trough level）在治療範圍內，避免中毒。鉀離子與此藥關聯性低，靜脈炎評估雖重要但非藥物毒性監測的第一優先，飲食內容與萬古黴素給藥無直接安全風險。
Vancomycin is both nephrotoxic and ototoxic, so prior to administration the nurse must ensure that renal function (serum creatinine) is adequate and that the trough drug level is within the therapeutic range in order to avoid toxicity. Potassium is poorly correlated with this medication. Although assessing for phlebitis is important, it is not the first priority for monitoring drug toxicity, and dietary content has no direct safety implications for the administration of vancomycin.
美台臨床均高度重視萬古黴素谷濃度檢測，但美國醫院藥師對於劑量調整與臨床諮詢的參與度通常比台灣更高。