# 一位 84 歲患有冠狀動脈疾病的病人，新處方為 liothyronine 25 mcg 每日。護理師應採取何種行動？

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=514126&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位 84 歲患有冠狀動脈疾病的病人，新處方為 liothyronine 25 mcg 每日。護理師應採取何種行動？

## 選項

1. 給予 50 mcg，因為老年人代謝甲狀腺激素較快。
2. 暫停劑量並澄清處方，因為仿單上標示老年人或心臟病病人的起始劑量為 5 mcg 每日。 **✔ 正確答案**
3. 給予劑量並僅在下次年度訪視時評估心絞痛。
4. 將藥物壓碎混入腸道餵食中，而不檢查給藥途徑或時間。

**正確答案: 2**

## 解析

老年人及有潛在心臟疾病的病人應從 liothyronine 5 mcg 每日開始，並以 5 mcg 的增量增加，以降低心臟不良反應的風險。

## 深入解析

快速答案
澄清25 mcg 起始劑量。

為何這是正確的
Liothyronine 會增加心率和收縮力，並可能引發心絞痛或心律不整。仿單規定老年人或心臟病病人應從 5 mcg 每日開始。

簡單類比或心像
敏感的引擎應從怠速啟動，而不是高速行駛。

記憶點
老年心臟：T3 起始劑量低且緩慢增加。

NCLEX 決策規則
在接受成人常用起始劑量之前，應考慮年齡和心血管狀況。

為何其他選項是錯誤的
劑量升級和延遲監測會增加心臟風險，而未經確認的給藥途徑改變無法解決劑量問題。參考資料
1DailyMed: Liothyronine Sodium老年人或心臟病病人從 5 mcg 開始

## 臨床情境

甲狀腺替代治療安全性
檢查年齡、冠狀動脈疾病、基準脈搏和心律、起始劑量、劑量調整間隔以及過度治療的症狀。

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