# 一位護理師正在衛教一位開始服用奧氮平的個案。護理師應強調哪一組追蹤監測參數？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391728&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一位護理師正在衛教一位開始服用奧氮平的個案。護理師應強調哪一組追蹤監測參數？

## 選項

1. 每3個月做ECG，並每季檢查血清鉀
2. 基準、12週後及之後至少每年監測體重/BMI、空腹血糖與血脂檢查 **✔ 正確答案**
3. 每6個月檢查甲狀腺功能組合與血清鈣
4. 每週PT/INR及每月aPTT

**正確答案: 2**

## 解析

正確 (2)：奧氮平在非典型抗精神病藥中具有最高的代謝風險——包括顯著的體重增加、新發生的第二型糖尿病和血脂異常。 美國糖尿病協會／美國精神醫學會共識監測時間表包括在基準值、12週時及至少每年一次的體重／身體質量指數、腰圍、空腹血糖和空腹血脂，以及血壓。 (1) 與齊拉西酮相比，奧氮平較不令人擔心 QT 間期延長；心電圖並非主要監測項目。 (3) 凝血試驗無關。 (4) 甲狀腺並非優先的代謝考量。

## 深入解析

Memory Tip: Highest metabolic — Olanzapine + Clozapine.

## 臨床情境

Scenario 36-year-old female with bipolar I starting olanzapine 10 mg HS; BMI 28.

## 重要概念

- **Metabolic syndrome** — Cluster of central obesity, dyslipidemia, insulin resistance, and hypertension.
- **ADA monitoring schedule** — Consensus protocol for tracking weight, glucose, and lipids.
- **Atypical antipsychotic** — Second-generation antipsychotic with lower EPS risk.

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