一位有青黴素過敏史的病人被處方 cefazolin。護理師的首要行動為何？
A client with a history of penicillin allergy is prescribed cefazolin. What is the priority action for the nurse?
- ARequest an alternative antibiotic from the provider✓ 正解向醫師請求更換其他抗生素
- BGive the drug with diphenhydramine與苯海拉明併用給藥
- CAdminister the drug and monitor for hives給藥並監測是否有蕁麻疹
- DPerform a skin test before administration給藥前進行皮膚試驗
頭孢菌素（Cefazolin）與青黴素結構相似，對於有嚴重過敏史（如過敏性休克）的病人，存在交叉過敏的風險。護理師應基於安全原則，主動聯繫開立醫師評估過敏嚴重度或更換其他類別抗生素。給藥後再觀察是極高風險行為，皮膚測試無法完全排除過敏反應。
Cefazolin, a cephalosporin, is structurally similar to penicillin; in patients with a history of severe allergy (such as anaphylactic shock), there is a risk of cross-allergy. Based on safety principles, the nurse should proactively contact the prescribing physician to assess allergy severity or change to another antibiotic class. Administering first and then observing is an extremely high-risk practice, and skin testing cannot completely exclude an allergic reaction.
台灣醫師有時會嘗試小劑量給予觀察，但美國依據 Safety Protocol 傾向直接更換，避免因過敏引發的醫療責任。