— 藥理與非經腸給藥 · MEDIUM · MCQ —
病人正接受靜脈注射萬古黴素，護理師觀察到病人臉部與頸部出現紅斑。護理師應優先採取何種措施？
A client is prescribed intravenous vancomycin. The nurse notes the client is developing red flushing on the face and neck. Which action is the priority?
- ASlow the infusion rate✓ 正解減慢輸注速率
- BAdminister an antihistamine immediately立即給予抗組織胺
- CNotify the provider for an order for epinephrine通知醫師開立腎上腺素醫囑
- DDiscontinue the infusion停止輸注
— Explanation · 中文詳解 —
此紅人症候群（Red Man Syndrome）為萬古黴素輸注速度過快引起的組胺釋放反應。處理原則是先減慢或停止輸注，症狀改善後再緩慢重新開始，無需立即給予抗組織胺或腎上腺素，除非出現真正的過敏性休克徵兆（如低血壓、呼吸困難）。
Red flushing on the face and neck indicates Red Man Syndrome, a histamine-mediated reaction caused by rapid vancomycin infusion. The priority action is to slow the infusion rate to mitigate the reaction, as discontinuation is unnecessary unless symptoms are severe. Antihistamines or epinephrine are reserved for true allergic responses or anaphylaxis, not for this common infusion-related side effect.
✦ 台美臨床差異
美台臨床對於減慢輸注的執行程序一致，但美國護理師常依據給藥守則直接執行，台灣常需先行聯絡醫師確認。