— 藥理與非經腸給藥 · MEDIUM · MCQ —
病人因重度子癇前症接受硫酸鎂靜脈輸注，下列哪項評估結果要求護理師立即停止輸注？
A client is receiving an IV infusion of magnesium sulfate for severe preeclampsia. Which assessment finding requires the nurse to immediately stop the infusion?
- ABlood pressure of 140/90 mmHg血壓 140/90 mmHg
- BUrine output of 40 mL per hour每小時尿量 40 mL
- CRespiratory rate of 16 breaths per minute呼吸頻率 16 次/分鐘
- DAbsent patellar deep tendon reflexes✓ 正解膝腱反射消失
— Explanation · 中文詳解 —
硫酸鎂中毒的首要臨床表徵為深層肌腱反射消失（DTRs loss），隨後呼吸抑制。當反射消失時，表示血清鎂濃度已達毒性等級，必須立即停藥並準備葡萄糖酸鈣作為拮抗劑。呼吸 16 次屬正常，血壓控制良好，尿量大於 30 mL/hr 顯示腎功能尚可排出藥物。
Absent deep tendon reflexes are an early sign of magnesium toxicity, requiring immediate discontinuation of the infusion. Respiratory depression follows loss of reflexes, so monitoring reflexes is crucial for safety during therapy.
✦ 台美臨床差異
美台臨床皆視深層肌腱反射為給藥指標，但台灣對於硫酸鎂給藥規範常由產科醫師嚴格把關，護理師監測頻率極高。