— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師正給予一位心臟衰竭病人 40 mg 的靜脈注射呋塞米（furosemide）。在給藥前，哪項評估發現最重要，應回報給醫師？
A nurse is administering furosemide 40 mg IV to a client with heart failure. Which assessment finding is most important to report to the physician before administering the medication?
- AClient has gained 3 lbs in the past week.病人過去一週體重增加 3 磅
- BAuscultating crackles in the lower lung fields.聽診下肺野有囉音
- CBlood pressure is 95/60 mmHg.✓ 正解血壓 95/60 mmHg
- DClient reports mild fatigue.病人主訴輕微疲倦
— Explanation · 中文詳解 —
呋塞米（Furosemide）作為強效環利尿劑（Loop diuretic），主要透過抑制鈉、鉀、氯的再吸收來增加尿量。若病人在低血壓的情況下給藥，會進一步減少有效循環血量，加重低血壓，甚至導致腎灌流不足或休克。在給藥前評估生命徵象（Vital signs）是護理師的安全職責，若血壓過低，必須暫停給藥並與醫師確認。
Furosemide is a potent loop diuretic that reduces fluid volume; administering it to a client with borderline or low blood pressure (95/60 mmHg) may exacerbate hypotension and compromise renal perfusion. While weight gain and crackles indicate fluid overload requiring diuresis, the hypotensive reading represents a safety risk that necessitates holding the medication and consulting the provider.