— 藥理與非經腸給藥 · HARD · MCQ —
護理師監測接受肝素（Heparin）靜脈點滴的病人。哪項檢驗值需要立即採取行動？
A nurse is caring for a client receiving a heparin infusion. Which laboratory value requires immediate action?
- AINR 1.2INR 1.2
- BHemoglobin 13 g/dL血紅素 13 g/dL
- CaPTT 65 secondsaPTT 65 秒
- DPlatelet count 85,000/mm³✓ 正解血小板計數 85,000/mm³
— Explanation · 中文詳解 —
肝素誘發的血小板減少症（HIT）是嚴重的免疫介導併發症。當血小板數目低於 100,000/mm³ 或下降幅度大於基線的 50%，必須高度懷疑 HIT，並立即停藥、通知醫師，以防止致死性的血栓事件發生。
Heparin-induced thrombocytopenia (HIT) is a serious immune-mediated complication. When the platelet count falls below 100,000/mm³ or decreases by more than 50% from baseline, HIT must be strongly suspected; the medication must be stopped immediately and the provider notified to prevent fatal thrombotic events.
✦ 台美臨床差異
美國護理師常依據醫院制定的肝素滴定流程表（Heparin Nomogram）直接調整劑量；台灣多需醫師確認後調整。