— 藥理與非經腸給藥 · MEDIUM · MCQ —
病人預計接受靜脈注射萬古黴素 1g 每 12 小時一次。護理師在給予下一劑前，應優先確認下列哪項檢驗數據？
A client is prescribed intravenous Vancomycin 1g every 12 hours. Which laboratory value should the nurse prioritize checking before administering the next dose?
- ATrough blood level✓ 正解血中波谷濃度
- BPeak blood level血中峰值濃度
- CWhite blood cell count白血球計數
- DSerum creatinine血清肌酸酐
— Explanation · 中文詳解 —
萬古黴素具腎毒性且治療窗窄，治療監測重點為波谷濃度（Trough level）。波谷濃度需在下一劑給藥前 30 分鐘抽取，以確保藥物濃度維持在治療範圍內，避免毒性累積或藥效不足。肌酸酐重要但非判斷當下劑量給予的直接依據。
Vancomycin has a narrow therapeutic index and potential nephrotoxicity, making trough levels critical to monitor before the next dose to ensure efficacy and prevent toxicity. While serum creatinine is important for assessing renal function, the trough level is the immediate priority for determining safe dosing intervals.
✦ 台美臨床差異
美台臨床對於萬古黴素 trough 的採血時間點嚴格程度一致，均以給藥前 30 分鐘為準。