病人預計進行靜脈腎盂造影（IVP）。護理師在檢查前應最優先確認哪項檢驗值？
A client is scheduled for an IV pyelogram (IVP). Which lab value should the nurse check first before the procedure?
- AWhite blood cell count白血球計數
- BHemoglobin level血紅素濃度
- CSerum creatinine✓ 正解血清肌酸酐
- DBlood glucose level血糖濃度
IVP 使用含碘造影劑，主要透過腎臟代謝，具有腎毒性風險。若病人腎功能受損（肌酸酐升高），造影劑可能誘發急性腎損傷（Contrast-induced nephropathy）。白血球、血紅素或血糖對此項放射科檢查的安全評估重要性較低。
Serum creatinine is the priority assessment because intravenous pyelograms use iodinated contrast media that are excreted by the kidneys and carry a risk of contrast-induced nephropathy. Elevated creatinine levels indicate impaired renal function, which increases the likelihood of acute kidney injury from the contrast dye. Other lab values like white blood cell count or hemoglobin do not directly assess the risk associated with contrast administration.
在美國，對顯影劑過敏或腎功能不全者的預防性補水（Pre-hydration）與 Mucomyst 使用有嚴格 Protocol；台灣亦有類似規範。