— 降低風險 · HARD · MCQ —
護理師照護一位第一型糖尿病病人，預計進行含對比劑的檢查，哪項護理行動最合適？
A nurse is caring for a client with Type 1 Diabetes who is scheduled for a diagnostic test with contrast dye. Which nursing action is most appropriate?
- AEnsure the client is NPO for 12 hours prior確保病人在檢查前禁食 12 小時
- BAdminister IV fluids to maintain hydration給予靜脈輸液以維持水合狀態
- CHold metformin for 48 hours before and after the procedure✓ 正解在手術前後停用 metformin 48 小時
- DHold the morning dose of insulin暫停當早劑量的胰島素
— Explanation · 中文詳解 —
針對使用含碘對比劑的檢查，服用 Metformin 的病人極易因對比劑誘發急性腎損傷，進而導致 Metformin 在體內蓄積，引發乳酸中毒（Lactic Acidosis）。故必須暫停服用該藥物，待腎功能確認正常後方可恢復，這是預防醫療相關併發症的重要護理重點。
Metformin must be held for 48 hours before and after procedures involving iodinated contrast dye because the dye can cause acute kidney injury. Renal impairment leads to the accumulation of metformin, significantly increasing the risk of life-threatening lactic acidosis. Nursing priority is to prevent this serious complication by ensuring the medication is withheld until renal function is confirmed normal.
✦ 台美臨床差異
兩地醫療指引對於 Metformin 與對比劑的停藥要求一致，皆列為病人安全檢查清單的必審事項。