# 審查周邊神經阻斷後的趨勢，並確定併發症和優先應對措施。 > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=515768&lang=zh-tw > language: zh-TW > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## 題目 審查周邊神經阻斷後的趨勢，並確定併發症和優先應對措施。 | Time | Data | | --- | --- | | 0 minutes | 布比卡因周邊神經阻斷完成；個案清醒；血壓 128/74 mm Hg；心率 82 次/分 | | 3 minutes | 新出現口周麻木、金屬味、耳鳴和躁動 | | 5 minutes | 全身性癲癇發作；血氧飽和度 86%；血壓 84/48 mm Hg | | 7 minutes | 儘管有氧氣和氣道支持，仍出現寬 QRS 波群心室心律不整 | Q1. 最可能的併發症是什麼？ 局部麻醉劑全身毒性 預期的阻斷作用開始 孤立的血管迷走神經事件 Q2. 哪種治療途徑是優先事項？ 再給予一次局部麻醉劑推注 啟動 LAST 清單並早期給予醫囑的 20% 脂肪乳劑 使用血管加壓素作為首選解毒劑 ## 解析 從口周麻木和耳鳴進展到癲癇發作、低血壓和心室心律不整是局部麻醉劑全身毒性，需要氣道支持和早期 20% 脂肪乳劑治療。 ## 深入解析 快速解答 辨識局部麻醉劑全身毒性 (LAST) 並啟動脂肪乳劑搶救途徑。 為何這是正確的 全身性局部麻醉劑暴露後，神經學症狀可能先於心血管衰竭。ASRA 清單優先考慮尋求協助、氣道和癲癇管理，以及早期 20% 脂肪乳劑，並採取 LAST 特定的復甦預防措施。 簡單類比或心像 警告聲變成電風暴；在病情惡化前，伸手拿取 LAST 搶救包。 記憶點 口麻、耳鳴、癲癇、心律不整：考慮 LAST 和脂肪乳劑。 NCLEX 決策規則 將神經學和心血管線索視為一個不斷演變的毒性症候群來追蹤。 為何其他選項是錯誤的 標準大劑量腎上腺素、血管加壓素、β 受體阻斷劑、鈣通道阻斷劑和更多的局部麻醉劑在清單中明確是不安全的選擇。References 1ASRA LAST ChecklistEarly 20% lipid emulsion, altered resuscitation, monitoring, and avoidance list ## 臨床情境 LAST 搶救 停止局部麻醉劑、呼叫協助、支持氣道、適當治療癲癇，並啟動醫囑的 20% 脂肪乳劑方案。 ## 相同主題題目 - [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=zh-tw) - [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=zh-tw) - [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=zh-tw) - [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=zh-tw) - [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=zh-tw) - [A nurse is monitoring a client receiving a continuous IV heparin infusion for pulmonary em…](https://mymerci.kr/pages/nclex_q.php?qn_id=363988&lang=zh-tw) - [A nurse is preparing to initiate a weight-based continuous IV unfractionated heparin infus…](https://mymerci.kr/pages/nclex_q.php?qn_id=364107&lang=zh-tw) - [A nurse is providing discharge teaching to a 65-year-old client newly prescribed warfarin …](https://mymerci.kr/pages/nclex_q.php?qn_id=364872&lang=zh-tw) ## 以其他語言閱讀 - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=515768&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=515768&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=515768&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=515768&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=515768&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。_