— 藥理與非經腸給藥 · HARD · SATA —
護理師照護服用華法林 (Warfarin) 的病人。下列哪些發現需立即回報醫師？（選所有適合的）
A nurse is caring for a client prescribed warfarin. Which findings should the nurse report to the healthcare provider immediately? (Select all that apply.)
- ABlack, tarry stools✓ 正解黑色柏油樣糞便
- BPresence of ecchymosis on the arms手臂出現瘀斑
- CBleeding gums while brushing teeth✓ 正解刷牙時牙齦出血
- DCoffee-ground emesis✓ 正解咖啡渣樣嘔吐物
- EHematuria✓ 正解血尿
— Explanation · 中文詳解 —
華法林為抗凝血劑，主要副作用為出血。黑便（腸胃道出血）、刷牙流血、咖啡色嘔吐物（上消化道出血）及血尿皆屬於嚴重出血徵象。瘀青（Ecchymosis）若非大面積或異常增生，通常為常見副作用，但若觀察到血尿或明顯黏膜出血，則代表凝血功能過度抑制，需立即調整劑量。
The nurse must immediately report signs of significant bleeding, such as black tarry stools, coffee-ground emesis, hematuria, and bleeding gums, as these indicate potential complications from warfarin therapy. Minor ecchymosis is a common side effect and typically does not require immediate reporting unless it is extensive or unusual.
✦ 台美臨床差異
台灣常規會囑咐病人出現這些狀況時需停藥回診，美國則強調隨時監測 INR 數值。