一位第二型糖尿病病人被開立二甲雙胍（Metformin），護理師應優先向醫師回報下列哪項評估結果？
A client with type 2 diabetes is prescribed metformin. Which assessment finding should the nurse prioritize reporting to the healthcare provider?
- AWeight loss of 2 pounds over the last month過去一個月體重減輕 2 磅
- BSerum creatinine level of 2.1 mg/dL✓ 正解血清肌酸酐濃度 2.1 mg/dL
- CBlood glucose level of 180 mg/dL血糖濃度 180 mg/dL
- DPatient report of mild nausea病人報告輕微噁心
Metformin 主要經由腎臟排泄，若腎功能受損（如肌酸酐升高），藥物易在體內堆積，增加乳酸中毒（Lactic Acidosis）之致命風險。肌酸酐 2.1 mg/dL 已顯示腎功能顯著下降，需評估劑量調整或停藥。其餘選項如噁心屬常見副作用，血糖值及體重減輕則非急性臨床緊急事件。
Metformin is primarily excreted by the kidneys, so impaired renal function, indicated by a serum creatinine level of 2.1 mg/dL, significantly increases the risk of lactic acidosis due to drug accumulation. This potentially fatal complication requires immediate provider notification for possible dose adjustment or discontinuation, whereas weight loss, mild nausea, and moderately elevated blood glucose are less urgent.
台灣針對 Metformin 在顯影劑檢查前的使用規範非常嚴謹，護理師需在檢查前 48 小時確認停藥。