病人預計進行靜脈腎盂造影 (IVP)，護理師詢問哪項問題對確保病人安全最為重要？
A client is scheduled for an intravenous pyelogram (IVP). Which question is most important for the nurse to ask to ensure client safety?
- A“When was the last time you had something to eat or drink?”「你上一次進食或飲水是什麼時候？」
- B“Do you have any allergies to shellfish or iodine?”✓ 正解「你是否對貝類或碘過敏？」
- C“Have you ever had a urinary tract infection before?”「你以前是否有過泌尿道感染？」
- D“Are you comfortable lying on a hard table for a long time?”「你覺得長時間躺在硬床上舒適嗎？」
核心概念：顯影劑安全評估。IVP 涉及靜脈注射含碘顯影劑。為何正確答案對：含碘顯影劑可能引發嚴重的過敏性休克（anaphylaxis），詢問對海鮮或碘的過敏史是辨識高風險病人的標準程序。為何其他選項錯：A（禁食）雖重要但主要針對胃部檢查或預防嘔吐；D 涉及舒適度而非立即生命危險；D 是病史與過敏風險無關。臨床思路：在「降低風險潛力」領域中，對侵入性或藥物介入的預防性篩檢（screening）是護理師發揮專業價值、避免醫療事故的核心行為。
Core concept: contrast media safety assessment. IVP involves intravenous administration of iodinated contrast. Why the correct answer is right: iodinated contrast can trigger severe anaphylaxis; asking about a history of allergy to shellfish or iodine is a standard procedure for identifying high-risk clients. Why the other options are wrong: A (fasting), while important, is primarily relevant for gastric studies or to prevent vomiting; C addresses comfort rather than immediate threat to life; C is medical history unrelated to allergy risk. Clinical reasoning: within the 'reduction of risk potential' domain, preventive screening before invasive procedures or medications is a core nursing behavior that adds professional value and prevents adverse events.
美國護理師在執行 IVP 前必須依據 Checklist 確認過敏史，若有過敏常需預給類固醇或抗組織胺；台灣實務上，此類過敏詢問通常包含在同意書簽署過程中，由護理師與放射科人員雙重核對。