— 降低風險 · MEDIUM · MCQ —
病人預計進行靜脈腎盂造影（IVP）。哪項評估發現最需要立即回報給醫師？
A client is scheduled for an intravenous pyelogram (IVP). Which assessment finding is most important to report to the provider?
- AHistory of claustrophobia有幽閉恐懼症病史
- BAllergy to shellfish or iodine✓ 正解對貝殼類或碘過敏
- CBlood pressure of 140/90 mmHg血壓 140/90 mmHg
- DDifficulty voiding排尿困難
— Explanation · 中文詳解 —
IVP 使用含碘對比劑（Contrast media）。對海鮮或碘過敏的病人發生過敏性休克的風險極高。幽閉恐懼症主要影響 MRI；排尿困難是 IVP 的適應症之一；血壓 140/90 雖高但非對比劑禁忌症。安全性評估（過敏史）是放射檢查前的首要任務。
IVP uses iodinated contrast media. Clients allergic to shellfish or iodine are at very high risk of anaphylaxis. Claustrophobia is more relevant to MRI; difficulty voiding is itself an indication for IVP; a blood pressure of 140/90 is elevated but is not a contraindication to contrast. Safety screening (allergy history) is the priority task before radiologic examination.
✦ 台美臨床差異
美國法規對過敏史篩查要求極嚴格，護理師需填寫詳細檢核表；台灣放射科亦有類似流程，重點在於知情同意書簽署。