護理師照護一位新開立靜脈輸注萬古黴素(Vancomycin)的病人,應監測哪些徵兆以預防「紅人症候群」?(選所有適合的)
A nurse is caring for a client with a new prescription for vancomycin IV. Which symptoms should the nurse monitor for signs of 'Red Man Syndrome'? (Select all that apply.)
- AFlushing of the face and neck✓ 正解面部和頸部潮紅
- BHypotension✓ 正解低血壓
- CHypertension高血壓
- DPruritus and rash on the upper body✓ 正解上身搔癢和皮疹
- EBradycardia心動過緩
紅人症候群(Red Man Syndrome)並非真正的過敏反應,而是萬古黴素輸注速度過快導致組織胺(Histamine)非免疫性釋放所引發的類過敏反應。臨床表現包括上半身皮膚潮紅、搔癢、蕁麻疹,以及組織胺造成的血管擴張引發低血壓。護理重點在於預防,建議輸注時間至少 60 分鐘以上。若發生此症狀,應立即暫停輸注,待症狀緩解後,依醫囑調慢輸注速度或給予抗組織胺。
Red Man Syndrome is a non-immune histamine release reaction caused by rapid vancomycin infusion, resulting in upper body flushing, pruritus, and rash. This massive vasodilation can lead to hypotension, whereas hypertension and bradycardia are not typical findings. Prevention involves infusing vancomycin over at least 60 minutes.
在美國臨床,萬古黴素給藥前常會確認藥物谷濃度(Trough level)及腎功能。對於紅人症候群的處理,美國護理師常依據預設醫囑(Standing order)直接減慢輸注速度或給予 Diphenhydramine,較少需像台灣常規需反覆請示醫師。