— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師正給予萬古黴素（vancomycin）的靜脈輸注。病人出現全身性皮疹並表示臉部潮紅。護理師應優先採取哪些行動？（選所有適合的）
A nurse is administering an IV infusion of vancomycin. The client develops a generalized rash and reports feeling flushed. The nurse should prioritize which action? (Select all that apply.)
- AStop the infusion.✓ 正解停止輸注
- BAdminister an antihistamine.✓ 正解給予抗組織胺
- CIncrease the infusion rate.加快輸注速率
- DNotify the physician.✓ 正解通知醫師
- EAssess the client's vital signs.✓ 正解評估病人的生命徵象
— Explanation · 中文詳解 —
題幹描述為典型的「紅人症候群」（Red Man Syndrome），這是萬古黴素輸注過快導致的非過敏性組織胺釋放反應。護理師應立即停止輸注以減少組織胺釋放，評估生命徵象確保循環穩定，通知醫師以取得醫囑給予抗組織胺（如 Diphenhydramine）來緩解症狀，並視情況在症狀緩解後減慢速度重新開始輸注。
The client is experiencing Red Man Syndrome, a histamine-mediated reaction caused by rapid vancomycin infusion. The nurse must immediately stop the infusion, assess vital signs for stability, notify the provider, and administer antihistamines to alleviate symptoms before potentially restarting at a slower rate.