— 藥理與非經腸給藥 · HARD · MCQ —
護理師準備經靜脈推注給予苯妥英 (phenytoin)。給藥過程中，下列哪項觀察會使護理師立即停止給藥？
A nurse is preparing to administer phenytoin via IV push. Which observation during the administration would cause the nurse to immediately stop the infusion?
- AThe patient develops bradycardia and hypotension✓ 正解病人出現心搏過緩與低血壓
- BThe patient reports mild metallic taste病人報告輕微的金屬味
- CThe heart rate drops from 80 to 75 bpm心跳從 80 降至 75 bpm
- DThe patient becomes sleepy病人變得嗜睡
— Explanation · 中文詳解 —
Phenytoin 靜脈推注時若速度過快，極易引起嚴重的心律不整（如緩脈）及低血壓。這是該藥物的已知嚴重副作用，因此給藥期間需持續心電圖及血壓監測。輕微味覺異常或輕度嗜睡為常見反應，非立即停止之理由。
Phenytoin must be administered slowly via IV push because rapid infusion can cause severe cardiovascular complications, including bradycardia and hypotension. The nurse should immediately stop the infusion if these signs occur, whereas mild metallic taste or sedation are expected, less critical side effects that do not require cessation of therapy.
✦ 台美臨床差異
美國多使用生理食鹽水稀釋且限速，台灣部分單位仍執行 IV Push，需嚴格控速。