# 一位個案已持續全身性強直陣攣性抽搐發作達 6 分鐘。靜脈通路通暢，且氧氣與抽吸設備皆已備妥。護理師應優先給予哪一項醫囑藥物？ > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=498496&lang=zh-tw > language: zh-TW > subject: Medical Emergencies > category: PA ## 題目 一位個案已持續全身性強直陣攣性抽搐發作達 6 分鐘。靜脈通路通暢，且氧氣與抽吸設備皆已備妥。護理師應優先給予哪一項醫囑藥物？ ## 選項 1. 給予醫囑的靜脈注射 levetiracetam 起始劑量 2. 立即給予醫囑的靜脈注射 lorazepam 劑量 **✔ 正確答案** 3. 給予醫囑的靜脈注射 fosphenytoin 起始劑量 4. 給予醫囑的口服 carbamazepine 維持劑量 **正確答案: 2** ## 解析 抽搐發作持續至少 5 分鐘即需依重積性癲癇治療。在已有靜脈通路的情況下，靜脈注射 benzodiazepine 類藥物如 lorazepam 是有效的初始治療，之後再給予長效抗癲癇起始藥物。 ## 深入解析 快速解答 立即給予醫囑的靜脈注射 lorazepam。持續抽搐超過 5 分鐘即視為重積性癲癇處理，benzodiazepine 是藥物治療的第一步。 為什麼這是正確的 長時間的抽搐發作會更難停止，並增加代謝、呼吸及神經損傷的風險。Lorazepam 能快速增強抑制性訊號傳遞，因此在靜脈通路已建立的情況下，是合適的初始治療。 簡單比喻或心智圖像 Lorazepam 就像緊急煞車，能在施加更持久的停車煞車前先減緩抽搐。這個比喻說明了順序，但呼吸道支持、劑量、監測及抽搐原因仍需積極處理。 記憶掛鉤 抽搐達 5 分鐘：先用 benzodiazepine，再給予長效癲癇控制藥物。 NCLEX 決策規則 對於活動性抽搐重積狀態且有靜脈通路者，應優先選用醫囑的靜脈注射 benzodiazepine，同時維持呼吸道與呼吸。若需持續控制，起始藥物如 levetiracetam 或 fosphenytoin 通常後續才給予。 為什麼其他選項是錯的 Levetiracetam 和 fosphenytoin 可作為第二階段的起始治療，但無法取代初始的 benzodiazepine。口服 carbamazepine 作用太慢，且在活動性抽搐期間給藥不安全。參考文獻 - [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing - [2]American Epilepsy Society: Convulsive Status Epilepticus GuidelinePubMed, National Library of Medicine ## 相同主題題目 - [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=zh-tw) - [A 68-year-old client with COPD is admitted with shortness of breath and SpO2 86% on room a…](https://mymerci.kr/pages/nclex_q.php?qn_id=362940&lang=zh-tw) - [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=zh-tw) - [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=zh-tw) - [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=zh-tw) - [A nurse is caring for a client prescribed Digoxin. Which nursing action is most appropriat…](https://mymerci.kr/pages/nclex_q.php?qn_id=375157&lang=zh-tw) - [A nurse is caring for a client prescribed Lithium. Which nursing action is most appropriat…](https://mymerci.kr/pages/nclex_q.php?qn_id=375233&lang=zh-tw) - [A nurse is caring for a client prescribed Spironolactone. Which nursing action is most app…](https://mymerci.kr/pages/nclex_q.php?qn_id=391869&lang=zh-tw) ## 以其他語言閱讀 - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=498496&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=498496&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=498496&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=498496&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=498496&lang=vi) --- More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw) _僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_