病人處於高血壓急症（Hypertensive crisis）。護理師應準備何種藥物？
A client is experiencing a hypertensive crisis. Which drug should the nurse prepare?
- AEpinephrine腎上腺素
- BAtropine阿托品
- CAspirin阿斯匹靈
- DNitroprusside✓ 正解硝普钠
高血壓急症（Hypertensive crisis）定義為收縮壓>180 mmHg 或舒張壓>120 mmHg，且伴隨急性器官損害。臨床目標為在數小時內平穩降低血壓，以防止進一步的器官受損。Nitroprusside 是強效且作用迅速的血管擴張劑，能直接作用於動脈與靜脈平滑肌，臨床上需透過靜脈輸注（IV infusion）給予，且因其半衰期極短，必須嚴密監測血壓。其他選項皆不具備急性降壓功能，甚至可能加重病情。
Hypertensive crisis is defined as a systolic blood pressure > 180 mmHg or diastolic > 120 mmHg with acute end-organ damage. The clinical goal is to lower blood pressure smoothly over several hours to prevent further organ injury. Nitroprusside is a potent, rapidly acting vasodilator that acts directly on arterial and venous smooth muscle. It is given by IV infusion, and because of its very short half-life, blood pressure must be monitored closely. The other options do not acutely lower blood pressure and may even worsen the condition.
在美國臨床，處理高血壓急症時，除了 Nitroprusside，常見藥物還包括 Labetalol 或 Nicardipine。護理師需特別注意 Nitroprusside 可能產生氰化物（Cyanide）中毒的副作用，需備妥硫代硫酸鈉（Sodium thiosulfate）作為解毒劑。