# 一名胸痛個案有舌下 nitroglycerin 的處方。給藥前最重要的評估問題是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397313&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一名胸痛個案有舌下 nitroglycerin 的處方。給藥前最重要的評估問題是什麼？

## 選項

1. 您在過去一小時內有用餐嗎？
2. 您偏好錠劑還是噴霧劑型？
3. 您最近有服用 sildenafil 或類似藥物嗎？ **✔ 正確答案**
4. 您有高血壓的家族史嗎？

**正確答案: 3**

## 解析

Nitroglycerin 與第五型磷酸二酯酶抑制劑並用可能引起嚴重的低血壓。護理師應在給予 nitroglycerin 前，評估個案近期是否使用過 sildenafil 或類似藥物。詢問飲食偏好或家族史無法因應立即的用藥安全風險。

## 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 Nitroglycerin 禁忌症確認的處置。

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 Nitroglycerin 禁忌症確認，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

- **Nitroglycerin** — 一種用於透過血管擴張來緩解心絞痛胸痛的硝酸鹽類藥物。
- **PDE-5 抑制劑** — 一類用於治療勃起功能障礙或肺動脈高壓的藥物，可能與硝酸鹽類藥物產生危險的交互作用。
- **低血壓** — 血壓異常偏低，可能影響組織灌流。

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