— 生理適應 · EASY · MCQ —
一位 45 歲高血壓患者服用 lisinopril。護理師在首次追蹤門診時，應優先評估哪項發現？
A 45-year-old client with a history of hypertension is prescribed lisinopril. Which assessment finding should the nurse prioritize during the initial follow-up visit?
- AMild nausea輕微噁心
- BPersistent dry cough✓ 正解持續性乾咳
- CPeripheral edema周邊水腫
- DOccasional headaches偶爾頭痛
— Explanation · 中文詳解 —
Lisinopril 屬於血管張力素轉換酶抑制劑（ACE inhibitor），其機轉為抑制 ACE，從而減少血管收縮。此藥最常見且最具代表性的副作用為持續性乾咳，這是因為緩激肽（Bradykinin）在肺部堆積所致。護理師必須評估此症狀，因為若咳嗽嚴重影響生活，醫師通常會評估將藥物更換為血管張力素受體阻斷劑（ARB）。
Lisinopril is an ACE inhibitor that prevents the breakdown of bradykinin, leading to its accumulation in the lungs and causing a persistent dry cough. This is a characteristic side effect that nurses must monitor, as it may necessitate switching the client to an angiotensin II receptor blocker if the cough becomes intolerable.