— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備為病人靜脈輸注萬古黴素（Vancomycin）。為了預防輸注相關反應，最重要的護理措施為何？
A nurse is preparing to administer IV vancomycin to a client. Which nursing action is most critical to prevent infusion-related reactions?
- ACheck the client's blood pressure every 5 minutes每 5 分鐘測量病人的血壓
- BAdminister the medication over at least 60 minutes✓ 正解至少於 60 分鐘內給藥
- CDilute the medication in 500 mL of normal saline以 500 mL 生理食鹽水稀釋藥物
- DPre-medicate with an antihistamine預防性給予抗組織胺
— Explanation · 中文詳解 —
萬古黴素輸注過快常引起「紅人症候群（Red Man Syndrome）」，特徵是軀幹上半部潮紅、低血壓和搔癢。遵循藥物學建議，每次給藥應至少稀釋並在 60 分鐘以上緩慢滴注，這能有效降低組織胺釋放的風險。若發生嚴重過敏或紅人症，應先暫停給藥並諮詢醫師。
Administering vancomycin over at least 60 minutes is the most critical action to prevent Red Man Syndrome, a reaction caused by rapid histamine release. Slowing the infusion rate effectively reduces the risk of this adverse effect, whereas concentration and pre-medication are secondary considerations. Monitoring blood pressure is necessary but does not prevent the reaction itself.
✦ 台美臨床差異
美國醫院常見有明確的 Vancomycin 輸注協定與過濾器使用規定；台灣臨床對於輸注時間的掌握依單位習慣略有不同。