— 藥理與非經腸給藥 · HARD · SATA —
護理師在靜脈給予苯妥英（Phenytoin）時，下列哪些措施是正確的？（選所有適合的）
Which of the following are appropriate nursing actions when administering phenytoin intravenously? (Select all that apply.)
- ADilute with normal saline only✓ 正解僅以生理食鹽水稀釋
- BAdminister at a rate not exceeding 50 mg/min✓ 正解給藥速率不得超過每分鐘 50 mg
- CMonitor for cardiac dysrhythmias✓ 正解監測心律不整
- DFlush the line with D5W before administration給藥前以 D5W 沖洗管路
- ECheck for vein patency prior to administration✓ 正解給藥前檢查靜脈通路是否暢通
— Explanation · 中文詳解 —
Phenytoin 靜脈給藥極易刺激血管，且與葡萄糖液（D5W）不相容會導致沉澱。給藥速率需嚴格控制在 50mg/min 以下，否則易引起心搏過緩或低血壓。給藥前後應確認靜脈管路通暢度，並使用生理食鹽水沖洗管路。
Phenytoin must be diluted exclusively with normal saline, as it precipitates in dextrose solutions like D5W. Administration should not exceed 50 mg/min to prevent severe cardiac dysrhythmias and hypotension, requiring continuous cardiac monitoring. Nurses must verify vein patency before infusion to avoid extravasation, which can cause significant tissue necrosis.
✦ 台美臨床差異
美台臨床皆將 Phenytoin 視為高警訊藥物（High Alert Medication），執行細節完全一致。