— 降低風險 · HARD · MCQ —
病人預計進行需使用顯影劑的診斷檢查。下列哪項評估對護理師而言在檢查前最為重要？
A client is scheduled for a diagnostic procedure requiring contrast dye. Which assessment is most important for the nurse to review prior to the procedure?
- ARecent fasting history最近的禁食歷史
- BSerum creatinine level✓ 正解血清肌酸酐數值
- CAllergy history to medications藥物過敏史
- DCurrent blood pressure當前血壓
— Explanation · 中文詳解 —
顯影劑（尤其是含碘顯影劑）具有腎毒性，可能引發顯影劑誘發之腎病變（CIN）。在進行檢查前，評估病人的腎功能（如肌酸酐值）是降低急慢性腎衰竭風險的最重要臨床依據。過敏史固然重要，但對於所有病人都應優先評估腎臟排泄功能。
Reviewing the serum creatinine level is critical because contrast dye can cause contrast-induced nephropathy, making renal function assessment a priority over other factors. While allergy history is important, evaluating kidney function ensures the client can safely excrete the dye, thereby preventing acute kidney injury.
✦ 台美臨床差異
美國多由電腦自動判讀肌酸酐來判斷檢查可行性；台灣護理師在接獲檢驗單時，常需人工核對數值並詢問醫師。