護理師正在指導病人如何自行使用舌下含服硝酸甘油（Nitroglycerin）以緩解胸痛。護理師應包含哪些指導內容？（選所有適合的）
A nurse is teaching a client about self-administration of sublingual nitroglycerin for chest pain. Which instructions should the nurse include? (Select all that apply.)
- ASit down before taking the medication.✓ 正解服用藥物前先坐下
- BSwallow the tablet with a full glass of water.用一杯水吞服藥片
- CTake one tablet every 5 minutes, up to a maximum of 3 doses.✓ 正解每 5 分鐘服用一片，最多 3 片
- DCall 911 if pain is not relieved after the first dose.✓ 正解若第一劑後疼痛未緩解，請撥打 911
- EStore the tablets in their original dark glass bottle.✓ 正解將藥片存放在原廠深色玻璃瓶中
硝酸甘油（NTG）是冠狀動脈疾病病人的急救藥物。選項 A 正確，因為 NTG 會導致強大的血管擴張，引發姿勢性低血壓，坐下可防跌倒。選項 B 錯誤，舌下錠應含在舌下吸收，吞服會因首渡效應（First-pass effect）失效。選項 C 正確，傳統用法是每 5 分鐘一顆，上限 3 顆。選項 D 正確且為最新的安全標準：若第一顆藥 5 分鐘後無效，應立即撥打 911（急救電話），因為這可能是心肌梗塞。選項 E 正確，NTG 對光和熱極敏感，必須存在避光玻璃瓶中，否則會失效。護理教育的重點在於正確的給藥方式、儲存條件以及何時尋求專業急救，這關係到病人的黃金救治時間。
Nitroglycerin causes systemic vasodilation, so the client should sit down to prevent falls from orthostatic hypotension. Sublingual tablets must be placed under the tongue for absorption; swallowing renders them ineffective due to first-pass metabolism. The standard protocol allows repeating the dose every 5 minutes up to three times, with emergency services called if pain persists after the first dose. Additionally, tablets must be stored in their original dark glass container to protect them from light and heat degradation.
美國心臟協會（AHA）近年強調「第一劑無效即打 911」；台灣部分衛教仍停留於「含完三顆無效才去急診」。護理師應根據最新實證，引導病人提早啟動急診流程，避免心肌大面積壞死。