— 生理適應 · MEDIUM · MCQ —
一位心房顫動的病患獲處方 warfarin。下列哪項評估為優先？
A client with atrial fibrillation is prescribed warfarin. Which assessment is priority?
- ABlood pressure血壓
- BSerum potassium血清鉀
- CPT/INR✓ 正解PT/INR
- DHeart rate心率
— Explanation · 中文詳解 —
Warfarin 是維生素 K 拮抗劑，直接影響凝血功能。PT/INR 是監測其藥效及評估出血風險的金標準。血壓與心率雖需監測，但與該抗凝血藥物的直接安全性關聯度低於凝血功能指標。鉀離子則與心律相關，與 warfarin 無直接藥理互動。
Warfarin is a vitamin K antagonist that directly affects coagulation, making the International Normalized Ratio (INR) the gold standard for monitoring therapeutic efficacy and assessing bleeding risk. While blood pressure and heart rate require monitoring, they are secondary to the direct safety concerns associated with anticoagulation therapy.
✦ 台美臨床差異
美國護理師常執行床邊照護點檢測 (POC) INR，台灣則多由檢驗科抽血，兩地護理師對報告判讀能力一致。