— 降低風險 · MEDIUM · MCQ —
一位病人預計接受需靜脈注射含碘對比劑（contrast media）的診斷檢查，護理師應優先評估下列何項？
A client is scheduled for a diagnostic procedure using IV iodinated contrast media. Which assessment is priority for the nurse to perform?
- AClient's preference for sedation病人對鎮靜的偏好
- BSerum creatinine and GFR✓ 正解血清肌酸酐和腎絲球過濾率 (GFR)
- CBlood glucose levels血糖水平
- DPresence of a peripheral IV line周邊靜脈輸液線的存在
— Explanation · 中文詳解 —
靜脈含碘對比劑經腎臟排泄，具腎毒性風險。檢查前評估腎功能指標（血清 creatinine 與 GFR）是預防對比劑相關急性腎損傷（contrast-associated AKI, CA-AKI）的關鍵步驟。若腎功能異常，可採取預防性靜脈水合或與醫師討論是否調整劑量、延後檢查或改用替代影像。C、A、D 雖然重要，但相較於 CA-AKI 風險，腎功能評估屬病人安全的優先項目。
Assessing serum creatinine and glomerular filtration rate (GFR) is the priority because iodinated contrast media is renally cleared and poses a risk for contrast-associated acute kidney injury. Identifying renal impairment beforehand allows for preventive measures such as hydration or alternative imaging strategies to ensure client safety.
✦ 台美臨床差異
美台對比劑檢查前皆需查腎功能，美國放射科醫師對腎功能指標的 cutoff 值執行非常嚴格。