— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師為吞嚥困難的病人發藥。哪項操作正確？
A nurse is administering medications to a client who has difficulty swallowing. Which action is appropriate?
- ACrush all pills and mix with applesauce將所有藥丸搗碎並混合蘋果泥
- BHide the pills in the client's meal將藥丸隱藏在病人的餐點中
- CGive the pills with a large amount of water給予大量水送服藥丸
- DConsult the pharmacy or provider about liquid alternatives✓ 正解諮詢藥局或醫師是否有液體替代劑
— Explanation · 中文詳解 —
並非所有藥物皆可磨碎（如腸溶衣劑型、緩釋劑型）。吞嚥困難時，首要應諮詢藥師是否有液體替代方案。磨碎藥物會改變吸收動力學甚至損害藥效。隱藏在餐點中（B）涉及倫理與用藥安全疑慮。給水（C）過多可能導致嗆咳。
Clients with dysphagia are at high risk for aspiration, so altering medication forms without verification is unsafe. Many medications, such as enteric-coated or sustained-release formulations, cannot be crushed or opened. The nurse should consult the pharmacy or provider to obtain liquid alternatives or other safe administration methods that do not compromise drug efficacy or patient safety.
✦ 台美臨床差異
台灣醫院多會建立「可磨碎藥物清單」，護理師需依此清單操作。