— 藥理與非經腸給藥 · HARD · MCQ —
護理師欲執行靜脈注射 Phenytoin。哪項護理措施為優先？
A nurse is administering a dose of phenytoin intravenously. What is the priority nursing action?
- AFlush the IV line with normal saline before and after administration✓ 正解給藥前後以生理食鹽水沖洗靜脈管路
- BMonitor the patient's blood pressure during administration給藥期間監測病人血壓
- CEnsure the patient is in a semi-Fowler's position確保病人採取半坐臥位（semi-Fowler's position）
- DAdminister the drug at a rate not exceeding 50 mg/min給藥速度不超過 50 mg/min
— Explanation · 中文詳解 —
Phenytoin 具強鹼性，若與其他輸液混合會產生沈澱結晶，導致血管阻塞。因此，給藥前需使用生理食鹽水沖洗管路，給藥後需再次沖洗以確保藥物完整進入循環。B 為安全劑量，但 A 的物理沈澱預防是給藥流程中最具技術性的關鍵。
Phenytoin is highly alkaline and can crystallize when mixed with other IV fluids, potentially causing vascular occlusion. The priority nursing action is to flush the IV line with normal saline before and after administration to ensure compatibility and complete delivery of the drug. While monitoring blood pressure and infusion rate are important safety measures, preventing physical precipitation is the critical technical step.
✦ 台美臨床差異
在美國，Phenytoin IV 給藥建議在大型血管中給予，台灣則有時使用專用管路。