— 生理適應 · HARD · MCQ —
一位 45 歲高血壓病史病人主訴突發嚴重頭痛及視力模糊，血壓 210/130 mmHg。下列哪項措施為優先？
A 45-year-old client with a history of hypertension reports a sudden onset of severe headache and blurred vision. Blood pressure is 210/130 mmHg. Which action is the priority?
- APrepare for rapid-acting IV antihypertensive administration✓ 正解準備給予快速作用的靜脈降壓藥
- BObtain an EKG取得心電圖
- CAdminister an oral antihypertensive medication給予口服降壓藥物
- DElevate the head of the bed to 30 degrees將床頭抬高 30 度
— Explanation · 中文詳解 —
此個案呈現高血壓急症（Hypertensive Emergency），出現標的器官損傷症狀（神經系統症狀），需立即靜脈給藥以控制血壓，預防腦中風或進一步損傷。口服藥物起效太慢，體位改變無法解決根本的高血壓問題，心電圖雖重要但應置於穩定血壓之後。
The client is experiencing a hypertensive emergency characterized by target organ damage, such as neurological symptoms. Immediate administration of rapid-acting intravenous antihypertensives is the priority to safely and quickly lower blood pressure and prevent further complications like stroke, as oral medications act too slowly for this critical situation.
✦ 台美臨床差異
美國 ICU 或急診護理師常依 protocol 直接給予靜脈降壓藥；台灣則通常必須由醫師親自評估後下達醫囑給予。