— 藥理與非經腸給藥 · HARD · MCQ —
一位因深部靜脈栓塞接受肝素治療的病人，其 aPTT 值為 120 秒，護理師應採取何項最適當措施？
A client receiving heparin therapy for DVT has an aPTT of 120 seconds. What is the most appropriate action for the nurse?
- AIncrease the heparin infusion rate增加肝素的輸注速率
- BContinue the infusion at the current rate以目前速率繼續輸注
- CAdminister Vitamin K給予維生素 K
- DStop the heparin infusion immediately and notify the provider✓ 正解立即停止肝素輸注並通知醫師
— Explanation · 中文詳解 —
治療性肝素輸注之 aPTT 目標值通常為對照值的 1.5-2.5 倍。120 秒已遠超出治療範圍，顯示出血風險極高。應立即暫停給藥並回報醫師調整醫囑，以避免致命出血併發症。維生素 K 是用於拮抗 Warfarin，非肝素解毒劑。
An aPTT of 120 seconds is significantly above the therapeutic range, indicating a high risk of hemorrhage. The nurse must immediately stop the heparin infusion and notify the provider to prevent serious bleeding complications, as vitamin K is not the antidote for heparin.
✦ 台美臨床差異
台灣醫院通常針對 aPTT 危急值有明確 protocol，護理師可先停藥後再通知醫師，流程與美國相似。