— 藥理與非經腸給藥 · HARD · MCQ —
甲狀腺機能亢進病人使用 propylthiouracil (PTU)，護理師應監測哪種優先併發症？
A client is diagnosed with hyperthyroidism and is prescribed propylthiouracil (PTU). The nurse should monitor the client for which priority complication?
- AHypoglycemia低血糖
- BAgranulocytosis✓ 正解粒細胞缺乏症
- CWeight gain體重增加
- DTachycardia心搏過速
— Explanation · 中文詳解 —
PTU 最嚴重且致命的副作用為顆粒性白血球缺乏症（Agranulocytosis）。病人在用藥期間若出現發燒、喉嚨痛或感染徵象，必須立即停藥並檢測白血球計數。A、C、D 皆與抗甲狀腺藥物相關或無直接關聯，但顆粒性白血球缺乏症會造成免疫崩潰，屬於致死性風險。
The priority complication to monitor for in a client taking propylthiouracil (PTU) is agranulocytosis, a potentially fatal drop in white blood cells that leads to severe infection. Nurses must instruct clients to immediately report signs of infection, such as fever or sore throat, as this indicates a critical immune compromise.
✦ 台美臨床差異
美台臨床皆強調用藥後發燒即需回診，台灣因健保便利性，病人通常能較快就醫檢測。