— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師照護一位接受靜脈注射萬古黴素 (vancomycin) 的病人。輸注開始後不久，觀察到病人臉部與頸部潮紅。護理師的首要行動為何？
A nurse is caring for a client who is prescribed intravenous vancomycin. The nurse observes flushing of the face and neck shortly after the infusion begins. What is the nurse's priority action?
- AAdminister an antihistamine給予抗組織胺
- BDiscontinue the medication permanently永久停止該藥物
- CContinue the infusion as this is a normal reaction繼續輸注，因為這是正常反應
- DSlow the rate of the infusion✓ 正解減慢輸注速度
— Explanation · 中文詳解 —
這是典型的 Red Man Syndrome，原因為藥物輸注速度過快導致組織胺大量釋放。首要處置是減慢輸注速度或暫停，待症狀緩解後再以較慢速度恢復輸注。這並非過敏反應，故無需永久停藥或立即施打抗組織胺。
The priority action is to slow the infusion rate, as the symptoms describe Red Man Syndrome caused by rapid histamine release rather than a true allergy. This condition typically resolves when the infusion is slowed or paused, and permanent discontinuation or immediate antihistamine administration is not required.
✦ 台美臨床差異
台灣醫院常規會要求 vancomycin 輸注時間需達 60-90 分鐘以上以預防此情況。