— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備給予病人 Vancomycin 1g IVPB，採取哪項護理措施能預防紅人症候群？
A nurse is preparing to administer Vancomycin 1g IVPB to a client. Which nursing action is essential to prevent Red Man Syndrome?
- AMonitor the client's blood pressure every 15 minutes每 15 分鐘監測病人的血壓
- BDilute the medication in at least 250mL of normal saline將藥物稀釋於至少 250mL 的生理鹽水中
- CAssess the peripheral IV site for infiltration評估周邊靜脈注射部位是否有滲漏
- DAdminister the infusion over at least 60 minutes✓ 正解至少於 60 分鐘內輸注完畢
— Explanation · 中文詳解 —
紅人症候群是因萬古黴素輸注速度過快導致組織胺釋放所致。給藥時間建議至少 60 分鐘，若劑量大於 1g 甚至需要更久。B 選項雖然稀釋亦屬必要，但控制輸注速率才是直接預防紅人症候群的關鍵機制。A 與 C 屬於常規監測，無法防範此種藥物反應。
Red Man Syndrome is caused by rapid infusion of vancomycin, which triggers histamine release; therefore, administering the drug over at least 60 minutes is essential to prevent this reaction. While dilution and monitoring are important, controlling the infusion rate is the primary preventive measure.
✦ 台美臨床差異
美國醫院藥局常會規範輸注時間，台灣護理師執行時需更嚴格確認藥袋上的限制速率。