— 生理適應 · HARD · MCQ —
一位 55 歲高血壓病史個案自訴劇烈頭痛、視力模糊，血壓 210/130 mmHg。優先處理為何？
A 55-year-old client with a history of hypertension reports severe headache and blurred vision. The BP reading is 210/130 mmHg. Which action is the priority?
- AInitiate continuous hemodynamic monitoring✓ 正解開始連續血流動力學監測
- BPlace the client in a supine position將客戶置於仰臥姿勢
- CReduce blood pressure rapidly within one hour在一小時內快速降低血壓
- DAdminister an oral antihypertensive medication給予口服抗高血壓藥物
— Explanation · 中文詳解 —
此為高血壓急症（Hypertensive Emergency），目標是監測神經學變化與確保器官灌流。必須使用靜脈輸注藥物控制，且不能過快下降以免誘發腦缺血。A 選項能精確評估血壓波動，是進行後續藥物治療前的必要準備。
This client is experiencing a hypertensive emergency requiring careful management to prevent organ damage while avoiding cerebral hypoperfusion. Continuous hemodynamic monitoring is essential to safely titrate IV antihypertensives and assess neurological status. Blood pressure should not be reduced rapidly, and oral medications act too slowly for this acute situation.
✦ 台美臨床差異
美國 ICU 護理師依醫囑滴定藥物頻率較高；台灣常需醫師每小時監測並記錄。