— 藥理與非經腸給藥 · MEDIUM · MCQ —
病人正接受靜脈滴注萬古黴素（Vancomycin），護理師在輸注期間應優先留意哪項發現？
A client is prescribed intravenous vancomycin. Which finding should the nurse prioritize during the infusion?
- AMild elevation in serum creatinine血清肌酸酐輕微升高
- BFlushing of the face and neck✓ 正解面部和頸部潮紅
- CInfusion site shows no signs of phlebitis輸注部位無靜脈炎跡象
- DPatient reports mild metallic taste病人主訴輕微金屬味
— Explanation · 中文詳解 —
萬古黴素快速輸注常見「紅人症候群（Red Man Syndrome）」，表現為上半身潮紅、搔癢及低血壓。這是由於組織胺釋放所致，應先暫停輸注並減慢速度，必要時給予抗組織胺。B 為長期用藥風險，C 為正常現象，D 非嚴重不良反應。
The nurse should prioritize flushing of the face and neck, which indicates Red Man Syndrome caused by rapid vancomycin infusion. This reaction results from histamine release and requires immediate intervention, such as pausing the infusion and slowing the rate. While nephrotoxicity is a concern, it is monitored over time rather than requiring immediate action during the infusion.
✦ 台美臨床差異
美台對萬古黴素監測均重視 Trough level，但美國護理師依據 protocol 調整給藥速度的情況較常見。