— 藥理與非經腸給藥 · HARD · SATA —
當護理師為病人施打 Gentamicin 時，下列哪些護理措施是必要的？（選所有適合的）
Which of the following nursing interventions are essential when administering Gentamicin to a client? (Select all that apply.)
- AMonitor peak and trough levels✓ 正解監測峰值和谷值濃度
- BAssess for signs of ototoxicity✓ 正解評估耳毒性跡象
- CEncourage increased fluid intake鼓勵增加液體攝取
- DMonitor serum creatinine levels✓ 正解監測血清肌酸酐濃度
- EAssess for signs of nephrotoxicity✓ 正解評估腎毒性跡象
— Explanation · 中文詳解 —
Gentamicin 為氨基糖苷類抗生素，具有明顯的耳毒性（Ototoxicity）與腎毒性（Nephrotoxicity）。治療期間必須定期監測血中藥物濃度（峰值與谷值）以調整劑量，並密切觀察腎功能指標（肌酸酐）及聽力變化，以確保病人安全。
Gentamicin has a narrow therapeutic index and carries risks of ototoxicity and nephrotoxicity, necessitating monitoring of peak and trough levels, serum creatinine, and signs of hearing loss or kidney dysfunction. While hydration is generally beneficial, it is not the primary monitoring parameter compared to drug levels and organ function tests.
✦ 台美臨床差異
美國醫院藥師通常會主動參與藥物動力學監測，台灣則多仰賴主治醫師與專科護理師共同評估。