# 在肌肉注射 haloperidol 5 mg 兩小時後，發現一位個案身體僵硬、出汗，體溫 39.8°C，血壓 168/96 mmHg，心跳 124 次/分，且意識混亂。此時優先的護理措施為何？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391725&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

在肌肉注射 haloperidol 5 mg 兩小時後，發現一位個案身體僵硬、出汗，體溫 39.8°C，血壓 168/96 mmHg，心跳 124 次/分，且意識混亂。此時優先的護理措施為何？

## 選項

1. 將個案安置於隔離室，30分鐘後再評估。
2. 因仍持續躁動，再給予haloperidol 2.5 mg IM。
3. 給予benztropine 2 mg IM以處理錐體外症狀。
4. 停止haloperidol，立即通知醫療提供者，並準備降溫與IV輸液。 **✔ 正確答案**

**正確答案: 4**

## 解析

正確答案 (2)：在抗精神病藥物給藥後出現肌肉僵硬、體溫過高、自主神經不穩定及意識狀態改變等一系列症狀，即為典型的抗精神病藥物惡性症候群 (NMS) — 若不及時治療，死亡率可高達 20% 的醫療緊急狀況。優先措施：停用致病藥物、立即通知醫師，並開始支持性照護（積極降溫、靜脈輸注晶體液、準備給予 dantrolene 及/或 bromocriptine）。(1) 錯誤 — benztropine 用於治療急性肌張力障礙及藥物引起的帕金森氏症，而非 NMS。(3) 錯誤 — 額外給予 haloperidol 會惡化 NMS，且有死亡風險。(4) 錯誤 — 隔離會延遲對致命性狀況的辨識及治療。

## 深入解析

Memory Tip: NMS = FEVER.

## 臨床情境

Scenario 34-year-old male received haloperidol 5 mg IM 2 hours ago; now rigid, febrile, tachycardic, hypertensive, confused.

## 重要概念

- **Neuroleptic malignant syndrome (NMS)** — Life-threatening reaction to antipsychotic medication.
- **Dantrolene** — Direct skeletal muscle relaxant used to treat NMS and malignant hyperthermia.
- **Extrapyramidal symptoms (EPS)** — Movement-related side effects of antipsychotics.

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