— 藥理與非經腸給藥 · MEDIUM · SATA —
一位心房顫動病人正在服用華法林（Warfarin）。護理師發現下列哪些徵象需要立即處理？（選所有適合的）
A client is receiving warfarin for atrial fibrillation. Which findings should the nurse identify as requiring immediate follow-up? (Select all that apply.)
- ADark, tarry stools✓ 正解黑色柏油樣糞便
- BTiny red spots on the skin (petechiae)✓ 正解皮膚出現細小紅點（瘀點）
- CInternational Normalized Ratio (INR) of 2.5國際標準化比值（INR）為 2.5
- DFrequent nosebleeds✓ 正解頻繁流鼻血
- EGingival bleeding while brushing teeth✓ 正解刷牙時牙齦出血
— Explanation · 中文詳解 —
華法林（Warfarin）是一種維生素 K 拮抗劑，透過抑制凝血因子合成達到抗凝血效果。治療目標是將國際標準化比值（INR）維持在治療窗內（通常為 2.0-3.0）。當藥物過量或病人凝血功能異常時，會出現出血傾向。護理師需監測潛在的出血徵兆，任何異常出血皆需立即評估，以防發生內出血或顱內出血等危及生命的併發症。
Warfarin therapy requires monitoring for signs of excessive anticoagulation, such as melena, petechiae, frequent nosebleeds, and gingival bleeding, as these indicate potential hemorrhage. An INR of 2.5 is within the therapeutic range and does not require immediate intervention.