— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備對癲癇病人執行苯妥英鈉靜脈輸注，下列何者為必要操作？
A nurse is preparing to administer phenytoin via IV piggyback to a client with a seizure disorder. Which action is necessary?
- AAdminister the dose over at least 30 minutes至少於 30 分鐘內給藥
- BMonitor for hypertensive crisis during infusion監測輸注期間的高血壓危象
- CFlush the intravenous line with normal saline before and after✓ 正解輸注前後以生理食鹽水沖洗靜脈管路
- DDilute the medication with dextrose 5% in water以 5% 葡萄糖溶液稀釋藥物
— Explanation · 中文詳解 —
苯妥英鈉（Phenytoin）具強鹼性，與多數藥物（如 D5W）混合會產生沉澱，因此給藥前後必須使用生理食鹽水沖管（Flush）以確保管路暢通並避免結晶堆積。D 錯誤（會沉澱）；C 應為緩慢給藥，但頻繁過快會導致低血壓；D 主要是低血壓而非高血壓風險。
Phenytoin is highly alkaline and precipitates when mixed with dextrose solutions, so it must be flushed with normal saline before and after administration to maintain line patency. Rapid infusion can cause severe hypotension and cardiac dysrhythmias, necessitating a slow rate rather than quick delivery.
✦ 台美臨床差異
台灣與美國對於 Phenytoin 的給藥流程規範高度一致，皆需嚴格遵守藥物相容性與輸注速度。