# 個案已接受肝素輸注5天。請點選需立即追蹤的檢驗結果。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=499743&lang=zh-tw  
> language: zh-TW  
> subject: Laboratory Values  
> category: ROR

## 題目

個案已接受肝素輸注5天。請點選需立即追蹤的檢驗結果。

![](https://mymerci.kr/data/nclex/hotspot/v4/v4_heparin_platelets.svg)

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복사

Original NCLEX Hotspot clinical education asset. Keep all options equally prominent; never add an answer marker, circle, arrow, highlight, title, or watermark.
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## 解析

血小板由240,000降至82,000/µL，下降超過50%。肝素暴露期間出現此型態需立即評估肝素誘發血小板低下。

## 深入解析

快速解答
血小板計數從 240,000/µL 降至 82,000/µL，在肝素暴露期間降幅超過 50%。此模式需要立即評估是否為肝素誘發的血小板減少症（heparin-induced thrombocytopenia）。

為何正確
血小板計數在肝素暴露期間下降超過一半。此時間點與下降幅度需要立即評估是否為肝素誘發的血小板減少症，而非單獨判斷最新的數值。

簡易類比或圖像聯想
將三個血小板數值想像成一個斜坡：臨床上重要的線索是在給予肝素期間，數值在數天內急遽下降。

記憶掛鉤
血小板從 240,000/µL 降至 82,000/µL 是與肝素相關的緊急趨勢。

NCLEX 決策規則
當肝素暴露伴隨血小板下降時，將當前計數與基礎值及時間點進行比較，然後針對此令人擔憂的模式進行通報。

為何其他選項錯誤
aPTT、血紅素和肌酸酐數值回答的是不同的監測問題；它們並未顯示出題目所要求之顯著的血小板趨勢。參考文獻

- [1]ASH：肝素誘發血小板減少症指引

## 臨床情境

臨床情境
個案已接受肝素輸注 5 天。

護理師應注意事項
血小板計數從 240,000/µL 降至 82,000/µL，在肝素暴露期間降幅超過 50%。此模式需要立即評估是否為肝素誘發的血小板減少症（heparin-induced thrombocytopenia）。

實務應用
當肝素暴露伴隨血小板下降時，將當前計數與基礎值及時間點進行比較，然後針對此令人擔憂的模式進行通報。

## 重要概念

- **Heparin-induced thrombocytopenia** — 一種與血栓形成和血小板下降相關的免疫媒介不良反應。
- **Platelet trend** — 血小板計數隨時間的變化，而非單一孤立的數值。

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