— 降低風險 · MEDIUM · MCQ —
護理師正在照顧一位有癲癇病史且被處方苯妥英鈉（phenytoin）的病人。病人報告經常跌倒。下列哪項潛在副作用最可能導致跌倒？
A nurse is caring for a client with a history of seizures who is prescribed phenytoin. The client reports experiencing frequent falls. Which potential side effect is most likely contributing to the falls?
- AGingival hyperplasia牙齦增生
- BSkin rash皮疹
- CNystagmus眼球震顫
- DAtaxia✓ 正解共濟失調
— Explanation · 中文詳解 —
苯妥英鈉（Phenytoin）是一種抗癲癇藥物，其治療指數狹窄，藥物濃度過高時常見的中樞神經系統毒性包括共濟失調（Ataxia）、眼球震顫（Nystagmus）及構音障礙。共濟失調會導致小腦功能受損，使病人步態不穩、平衡感喪失，這是造成跌倒最直接且關鍵的臨床因素。護理師在評估跌倒風險時，應優先考量藥物對神經系統的影響，並建議監測血清藥物濃度。
Ataxia, or lack of coordination, is a common central nervous system side effect of phenytoin toxicity that directly impairs balance and gait. This unsteadiness significantly increases the risk of falls, making it the most likely contributor to the client's reported incidents.