— 藥理與非經腸給藥 · HARD · MCQ —
一位病人因嚴重的葡萄球菌感染被處方萬古黴素（Vancomycin）。護理師應優先監測哪種不良反應？
A client is prescribed vancomycin for a severe Staphylococcal infection. The nurse should prioritize monitoring for which adverse effect?
- AHypoglycemia低血糖
- BOtotoxicity✓ 正解耳毒性
- CPeripheral neuropathy周邊神經病變
- DPhotosensitivity光敏感性
— Explanation · 中文詳解 —
萬古黴素具有耳毒性與腎毒性。耳毒性通常是劑量相關或因波谷濃度過高引起，臨床上表現為耳鳴、暈眩或聽力減退。在用藥期間，護理師需嚴格監測血中濃度（Trough level）並觀察病人聽覺狀況，以預防永久性的聽力受損。
Vancomycin is associated with significant ototoxicity and nephrotoxicity, making hearing loss a priority adverse effect to monitor. Nurses should assess for symptoms such as tinnitus, dizziness, or decreased hearing and monitor trough levels to prevent permanent damage to the eighth cranial nerve.
✦ 台美臨床差異
美國醫院執行萬古黴素給藥多需依據藥師計算的波谷濃度調整；台灣亦同，但針對耳毒性監測的衛教深度可能因醫療制度而有差異。