# 一名兒童在接受美托拉麥治療期間出現異常動作。請將每個陳述拖曳到適當的類別中。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522648&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一名兒童在接受美托拉麥治療期間出現異常動作。請將每個陳述拖曳到適當的類別中。

**1.** 停止美托拉麥並尋求緊急評估

Select a category
Unsafe response
Protective response

**2.** 保護呼吸道並評估動作模式和生命徵象

Select a category
Unsafe response
Protective response

**3.** 記錄暴露情況並避免在無監督下再次挑戰

Select a category
Unsafe response
Protective response

**4.** 提早給予下一劑以抑制異常動作

Select a category
Unsafe response
Protective response

**5.** 告知照護者向上凝視是預期的

Select a category
Unsafe response
Protective response

**6.** 在未經審查的情況下繼續用藥數月

Select a category
Unsafe response
Protective response

## 解析

頸部扭曲、向上凝視、面部扭曲和不自主舌頭運動是錐體外徑危險徵兆。應停止美托拉麥並緊急評估，而不是繼續或增加劑量。

## 深入解析

快速解答
將保護性反應與延長多巴胺阻斷暴露的行動分開。

為何這是正確的
兒童對錐體外徑反應的脆弱性增加，遲發性運動障礙可能是不可逆的。治療持續時間和累積暴露會增加風險。

簡單類比或心像
採用以家庭為中心的用藥安全循環：確認年齡或懷孕狀況、識別暴露和新線索、預防進一步傷害、穩定個案，並確認反應。

記憶點
族群、適應症、劑量或途徑、禁忌症、緊急線索、保護措施和再評估。

NCLEX 決策規則
選擇能保護產婦、新生兒或兒科個案免受最直接藥物相關傷害，同時保留授權治療的措施。

為何其他選項是錯誤的
將危險徵兆正常化、替代未經批准的途徑或劑量，或延遲再評估的選項，會使個案暴露於可預防的傷害中。References
1DailyMed: metoclopramide tabletsTardive dyskinesia boxed warning, pediatric extrapyramidal risk, neonatal methemoglobinemia risk, and discontinuation for abnormal movements

## 臨床情境

產婦、新生兒和兒科用藥安全審查
確認個案的年齡或懷孕階段、適應症、體重或實驗室背景、途徑、相互作用療法、禁忌症、照護者衛教和可衡量的後續追蹤。

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