— 藥理與非經腸給藥 · HARD · MCQ —
護理師照顧服用 phenytoin 的病人，下列何者評估為最高優先級？
A nurse is caring for a client receiving phenytoin. Which assessment is the highest priority?
- AMonitoring for skin rashes✓ 正解監測皮膚紅疹
- BSerum albumin levels血清白蛋白濃度
- CGingival hyperplasia presence牙齦增生情況
- DBlood pressure during administration給藥期間的血壓
— Explanation · 中文詳解 —
Phenytoin 與嚴重皮膚藥物反應（如 SJS/TEN）相關，雖然牙齦增生常見，但皮膚紅疹具有生命威脅，屬最高優先級，需立即評估並停藥。白蛋白會影響藥物結合率，但非急性致命指標；靜脈輸注時需監測心律與血壓，但皮膚反應是持續性治療中的關鍵監控點。
Phenytoin can cause severe, life-threatening skin reactions such as Stevens-Johnson syndrome, making skin assessment the highest priority. While gingival hyperplasia and albumin levels are relevant, they are not immediately life-threatening emergencies compared to severe dermatologic reactions.
✦ 台美臨床差異
台灣針對亞洲人種常進行 HLA-B*1502 基因檢測以預防此藥物過敏，美國則視情況而定。