— 藥理與非經腸給藥 · HARD · SATA —
護理師準備給藥，哪些藥物醫囑需要向醫師確認？（選所有適合的）
A nurse is preparing to administer several medications to a client. Which medications should the nurse clarify with the provider? (Select all that apply.)
- AMetformin for a client scheduled for a CT scan with contrast✓ 正解為即將接受含顯影劑 CT 掃描的病人開立 Metformin
- BLisinopril for a client with a history of angioedema✓ 正解為有血管性水腫病史的病人開立 Lisinopril
- CLevothyroxine for a client with a history of hypothyroidism為有甲狀腺功能低下病史的病人開立 Levothyroxine
- DMorphine sulfate for a client with a respiratory rate of 8 breaths/min✓ 正解為呼吸頻率 8 次/分的病人開立 Morphine sulfate
- EDigoxin for a client with a heart rate of 54 bpm✓ 正解為心率 54 bpm 的病人開立 Digoxin
— Explanation · 中文詳解 —
護理師需運用批判性思考檢視醫囑安全性。A：Metformin 需在顯影劑檢查前後暫停，以免乳酸中毒。B：血管性水腫病史禁用 ACEI。D：呼吸過慢禁用嗎啡。E：Digoxin 通常在心跳 <60 bpm 時應停藥。Levothyroxine 是甲狀腺功能低下常規用藥，無禁忌。
The nurse must clarify orders for metformin, lisinopril, morphine sulfate, and digoxin due to specific safety risks. Metformin should be held before contrast imaging to prevent lactic acidosis, while lisinopril is contraindicated in clients with a history of angioedema. Additionally, morphine is unsafe given the client's respiratory depression, and digoxin should be withheld for bradycardia.
✦ 台美臨床差異
美國護理師對藥物安全有極高的自主裁決權（Right to hold），台灣護理師通常需醫師確認後才能正式停藥。