# 標示出在給予產時 B 型鏈球菌預防性治療前需要後續追蹤的發現或醫囑。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=516663&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

標示出在給予產時 B 型鏈球菌預防性治療前需要後續追蹤的發現或醫囑。

| 領域 | 發現或醫囑 |
| --- | --- |
| Microbiology | 產前陰道直腸篩檢 B 型鏈球菌陽性 |
| Labor | 有規律宮縮和子宮頸變化 |
| Allergy | 先前青黴素暴露引起過敏性休克和低血壓 |
| Susceptibility | GBS 分離株沒有記錄的克林黴素藥敏結果 |
| Prescription | 醫囑在分娩後口服克林黴素 |
| Maternal status | 體溫 37.0 C |
| Fetal status | 胎心率基線為 140/分，中度變異性 |
| History | 病人接受了常規兒童期免疫接種 |

## 解析

產時 GBS 篩檢陽性需要產時預防性治療，而既往過敏性休克、缺乏克林黴素藥敏性、口服門診醫囑以及計畫延遲至分娩後給予，則需要立即澄清。

## 深入解析

快速解答
驗證過敏嚴重程度、途徑、時機和藥敏性。

為何這是正確的
產時靜脈注射抗生素可降低新生兒 GBS 傳播。高風險青黴素過敏會改變藥物選擇，而克林黴素的使用取決於藥敏性；治療必須在分娩期間進行，而不是分娩後。

簡單類比或心像
在分娩進展前選擇正確的鑰匙，並透過能到達產時窗口的途徑遞送。

記憶點
分娩時 GBS：立即靜脈預防；嚴重過敏需要考慮藥敏性的替代方案。

NCLEX 決策規則
標示任何會改變預防性治療是否適用、哪種藥物安全，或途徑和時機是否可行的發現。

為何其他選項是錯誤的
正常的體溫和令人放心的胎心率並不能糾正不安全的過敏或給藥途徑計畫。References
1CDC: Prevention of Perinatal Group B Streptococcal Disease產時靜脈預防、過敏評估和藥敏性指導的替代選擇

## 臨床情境

GBS 預防性治療檢查
確認培養結果、分娩狀態、胎膜狀態、過敏反應、分離株藥敏性、靜脈途徑、藥物、劑量、時機和新生兒溝通。

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