一位有高血壓病史的病人，若接到醫囑包含下列哪項藥物，護理師應提出質疑？

核心概念：高血壓（Hypertension）病人應避免的藥物。 為何正確答案對： C. 布洛芬（Ibuprofen）屬於非類固醇抗發炎藥物（Nonsteroidal anti-inflammatory drugs, NSAIDs）。NSAIDs 會抑制前列腺素（Prostaglandins）的合成，這可能導致腎臟血流減少、鈉離子和水分滯留（Sodium and water retention），進而升高血壓。此外，NSAIDs 也可能降低某些抗高血壓藥物（如 ACEI、ARB、利尿劑）的療效。因此，對於有高血壓病史的病人，若醫師開立 NSAIDs，護理師應提出質疑，並與醫師討論其必要性與潛在風險。 為何其他選項錯： A. 賴諾普利（Lisinopril）是血管張力素轉化酶抑制劑（ACE inhibitor），常用於治療高血壓，有助於降血壓。 B. 氨氯地平（Amlodipine）是鈣離子通道阻斷劑（Calcium channel blocker），也是常用於治療高血壓的藥物。 D. 美托洛爾（Metoprolol）是乙型阻斷劑（Beta-blocker），常用於治療高血壓和心絞痛，有助於降低血壓。 臨床思路（Pharmacological Therapies/Safety）：在給藥前，護理師必須了解藥物的藥理作用及其與病人原有病史的潛在交互作用。對於高血壓病人，應特別注意可能導致血壓升高的藥物。

Core concept: medications that should be avoided in clients with hypertension. Why the correct answer is right: C. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs inhibit prostaglandin synthesis, which can decrease renal blood flow and cause sodium and water retention, thereby raising blood pressure. In addition, NSAIDs can blunt the effectiveness of certain antihypertensive agents (such as ACE inhibitors, ARBs, and diuretics). Therefore, in a client with a history of hypertension, if an NSAID is prescribed, the nurse should question the order and discuss the necessity and potential risks with the physician. Why the other options are wrong: A. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat hypertension and helps lower blood pressure. B. Amlodipine is a calcium channel blocker also commonly used to treat hypertension. D. Metoprolol is a beta-blocker commonly used to treat hypertension and angina, helping to lower blood pressure. Clinical reasoning (Pharmacological Therapies/Safety): Before administering medication, the nurse must understand the drug's pharmacologic actions and its potential interactions with the client's existing history. In clients with hypertension, special attention should be paid to medications that may raise blood pressure.