— 藥理與非經腸給藥 · HARD · MCQ —
病人正接受靜脈輸注萬古黴素（Vancomycin）。輸注期間，護理師觀察到下列何種發現最需擔憂？
A client is prescribed intravenous vancomycin. Which finding would be most concerning to the nurse during the infusion?
- AFlushing of the face and neck臉部與頸部潮紅
- BMild soreness at the IV site靜脈注射部位輕微疼痛
- CBlood pressure drop and wheezing✓ 正解血壓下降與喘鳴聲
- DDevelopment of a fine maculopapular rash出現細小的斑丘疹
— Explanation · 中文詳解 —
選項 A 是紅人症候群（Red Man Syndrome），由輸注過快引起，雖常見但不致命，減慢速度即可改善。選項 C 出現血壓下降（低血壓）與喘鳴（支氣管痙攣），這是嚴重的過敏性休克（Anaphylaxis），需立即停止給藥並啟動緊急搶救，具致命風險，因此最需擔憂。
Hypotension and wheezing indicate anaphylaxis, a severe, life-threatening allergic reaction that requires immediate cessation of the infusion and emergency intervention. Although flushing suggests Red Man Syndrome, it is a manageable side effect of rapid infusion and is not as critical as signs of anaphylactic shock.
✦ 台美臨床差異
兩地均強調萬古黴素需精確計算時間與濃度，台灣醫院對於藥物過敏反應的處理流程非常嚴謹，尤其重視急性休克的即時反應。