# 一名CKD貧血個案使用epoetin alfa，例行BP 162/96且Hgb 12.5。護理師優先行動是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391831&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名CKD貧血個案使用epoetin alfa，例行BP 162/96且Hgb 12.5。護理師優先行動是什麼？

## 選項

1. 依醫囑給藥
2. 增加劑量以改善效果
3. 只加給降血壓藥
4. 暫停本次劑量並通知醫療者；CKD中Hgb >11和血壓升高都是黑框警示相關問題，目標Hgb 10-11可減少心血管事件 **✔ 正確答案**

**正確答案: 4**

## 解析

正確（2）：ESA（epoetin alfa、darbepoetin）有FDA黑框警示；Hgb >11 g/dL或快速上升會增加心血管事件、血栓和中風。CKD目標Hgb為10-11。高血壓是常見劑量相關副作用。應暫停並通知調整。（1、3）增加風險。（4）仍需處理ESA。

## 深入解析

記憶提示 ESA刺激紅血球生成；CKD目標Hgb只有10-11。越高越容易血栓/中風。監測血壓和鐵儲存。

## 臨床情境

情境 65歲男性CKD因貧血使用epoetin alfa SC。今日：BP 162/96、Hgb 12.5。

## 重要概念

- **紅血球生成刺激劑（ESA）** — 包括epoetin alfa、darbepoetin；治療CKD貧血與化療相關貧血。
- **ESA黑框警示** — Hgb >11或快速上升會增加心血管事件、血栓與中風。
- **ESA相關高血壓** — 常見劑量相關副作用；每次就診都需監測血壓。

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