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藥理與非經腸給藥 · MEDIUM · MCQ

護理師準備為一位感染 MRSA 的病人靜脈注射萬古黴素(Vancomycin)。哪項行動對於確保用藥安全至關重要?

The nurse is preparing to administer vancomycin intravenously to a client with MRSA. Which action is essential to ensure safe administration?

  • ARestrict fluid intake during the therapy
    治療期間限制液體攝取
  • BInfuse the medication over at least 60 minutes✓ 正解
    將藥物於至少 60 分鐘內輸注完畢
  • CAdminister via rapid IV push
    經快速靜脈推注給藥
  • DCheck the client's blood glucose before administration
    給藥前檢查病人的血糖
Explanation · 中文詳解

Vancomycin 輸注速度過快會引發「紅人症候群」(Red Man Syndrome),這是一種假性過敏反應,導因於組織胺的大量釋放,症狀包括臉部、頸部及上半身出現紅疹、低血壓和心跳過快。為了預防此現象,標準做法是將每劑藥物稀釋後,輸注時間至少維持 60 分鐘或更久。快速推注(C)是絕對禁忌,可能導致嚴重的血壓驟降。Vancomycin 不影響血糖(D),且由於其具有腎毒性,反而應鼓勵病人多喝水以利排泄(A),而非限制水分。護理師的核心責任是監測輸注速率與觀察皮膚反應。

To prevent Red Man Syndrome, a histamine-mediated reaction caused by rapid vancomycin infusion, the medication must be administered slowly over at least 60 minutes. This reaction can cause severe flushing, hypotension, and tachycardia, making controlled infusion rates critical for patient safety. Nurses should also encourage adequate fluid intake to mitigate nephrotoxicity risks associated with the drug.

✦ 台美臨床差異

美國 NCLEX 考試極高頻率考 Red Man Syndrome 的處置。在台灣臨床,護理師習慣使用輸液幫浦(Pump)設定時間,但有時會因臨床忙碌而加快流速,需嚴格遵守藥劑科規定的 60-120 分鐘準則。

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