# 護理師正在給予睪丸癌個案cisplatin。哪些護理介入對降低毒性是必要的？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391864&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

護理師正在給予睪丸癌個案cisplatin。哪些護理介入對降低毒性是必要的？

## 選項

1. 每日ASA保護腎臟
2. 鼓勵最低限度攝水以減少腎臟工作
3. 積極IV補液加mannitol利尿、預防性止吐（5-HT3 + dexamethasone + NK1）、基線與連續creatinine、電解質（Mg/K）及聽力檢查 **✔ 正確答案**
4. 避免止吐藥以觀察真正腸胃耐受性

**正確答案: 3**

## 解析

正確（2）：Cisplatin具有高度腎毒性、耳毒性與催吐性。標準照護包括積極補液±mannitol利尿、基線/連續Cr與電解質（尤其Mg、K）、聽力檢查，以及三合一止吐（5-HT3 + dexamethasone + NK1 antagonist）。（1、3、4）都有害。

## 深入解析

記憶提示 Cisplatin要想到腎、耳、強烈噁心。補液、電解質、聽力與止吐要一起做；某些療程可用amifostine作細胞保護。

## 臨床情境

情境 38歲男性因睪丸癌開始使用cisplatin。

## 重要概念

- **Cisplatin 白金化療** — 白金類化療；具腎毒性、耳毒性、神經毒性與高度催吐性。
- **積極IV補液** — 在cisplatin前、中、後進行，以降低腎毒性。
- **聽力檢查** — 針對cisplatin耳毒性的基線與連續聽力測試。

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