# 一位接受 gentamicin 治療的個案主訴耳鳴，且血清肌酸酐數值上升。在給予下一劑藥物前，護理師應採取何種行動？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397311&lang=zh-tw  
> language: zh-TW  
> subject: Medication Administration  
> category: PPT

## 題目

一位接受 gentamicin 治療的個案主訴耳鳴，且血清肌酸酐數值上升。在給予下一劑藥物前，護理師應採取何種行動？

## 選項

1. 給予劑量，因為耳鳴是感染時預期會出現的症狀。
2. 暫停給藥並通知醫師。 **✔ 正確答案**
3. 將藥物與葡萄柚汁一起服用。
4. 請求開立 loop diuretic 的醫囑。

**正確答案: 2**

## 解析

Aminoglycoside 類藥物可能引起耳毒性及腎毒性。耳鳴和肌酸酐上升是警訊，因此護理師應暫停給藥並在給藥前通知醫師。給予劑量或增加具腎毒性的藥物可能會加重損傷。

## 深入解析

臨床判斷
利用個案線索、時間點、檢驗數據及安全風險，選擇最符合 Gentamicin 毒性線索的處置。

記憶提示
將最強的線索群與最安全的護理判斷配對。

KR vs US
NCLEX 考題獎勵基於線索的優先思考，而非單獨的記憶。

## 臨床情境

臨床實務指引
對於 Gentamicin 毒性線索，請將完整的線索模式與個案當前的穩定度、醫囑數據及預期的護理執業範圍進行比較。

注意
當完整情境改變了優先順序或安全性時，不要僅根據單一線索選擇行動。

## 重要概念

- **Aminoglycoside** — 一類與腎毒性及耳毒性相關的抗生素。
- **耳毒性** — 藥物對聽力或平衡結構造成的損傷。
- **血清肌酸酐** — 用於評估腎功能的實驗室指標。

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